Marty Ray Sandvig

NPI #1831596469 in Chaska, Minnesota

Provider Information

NPI Number: 1831596469
Entity Type: Individual
Name: Marty Ray Sandvig
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Nov 25, 2014
Last Updated: Nov 25, 2014

Practice Location

Address: 111 PIONEER TRL
City: Chaska
State: Minnesota
ZIP Code: 55318-1121
Phone: (952) 361-3766

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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