Individual
STACEY MATERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1444 147TH AVE NE, SUITE 250, HAM LAKE, MN 55304-4971
(763) 208-5382
(763) 208-2911
Mailing address
4741 REGENT AVE N, CRYSTAL, MN 55429-3740
(651) 341-9194
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5811
MN
Other
Enumeration date
06/07/2013
Last updated
06/11/2013
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