Individual
MARTY RAY SANDVIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 PIONEER TRL, CHASKA, MN 55318-1121
(952) 361-3766
(952) 679-3190
Mailing address
111 PIONEER TRL, CHASKA, MN 55318-1121
(952) 361-3766
(952) 679-3190
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
118821
MN
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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