Individual
JOHN DERRICK MARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
6642 PENN AVE S, RICHFIELD, MN 55423-2026
(612) 861-2752
(612) 861-2752
Mailing address
6642 PENN AVE S, RICHFIELD, MN 55423-2026
(612) 861-2752
(612) 861-2752
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2891
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4C297S0
BLUE CROSS CLINIC NUMBER
MN
01
—
4C298MA
BLUE CROSS PROVIDER
MN
Enumeration date
05/04/2007
Last updated
07/08/2007
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