Individual
JONATHAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1811 WEIR DR STE 275, WOODBURY, MN 55125-2201
(612) 594-8178
Mailing address
9556 CRESCENT LN, WOODBURY, MN 55125-8546
(651) 233-7174
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120356
MN
Other
Enumeration date
06/08/2018
Last updated
06/08/2018
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