Organization
MARTY CHIROPRACTIC-EXCELSIOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP MARK MARTY DC (PRESIDENT & CHIEF EXECUTIVE OFFICIE)
(952) 474-4121
Entity
Organization
Contact information
Practice address
464 SECOND STREET, SUITE 200, EXCELSIOR, MN 55331
(952) 474-4121
(952) 474-8391
Mailing address
464 SECOND STREET, SUITE 200, EXCELSIOR, MN 55331
(952) 474-4121
(952) 474-8391
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10872MA
BCBS
MN
Enumeration date
07/27/2006
Last updated
08/22/2020
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