Individual
DR. JEREMY GLEN MARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
18476 KENRICK AVE, SUITE 201, LAKEVILLE, MN 55044-9288
(612) 440-5776
(952) 236-6732
Mailing address
18476 KENRICK AVE, SUITE 201, LAKEVILLE, MN 55044-9288
(612) 440-5776
(952) 236-6732
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6189
MN
Other
Enumeration date
01/25/2016
Last updated
10/24/2016
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