Provider Demographics
NPI:1619743069
Name:MARTI, JESSICA L (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:L
Last Name:MARTI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 MCADAM RD
Mailing Address - Street 2:
Mailing Address - City:CUBA CITY
Mailing Address - State:WI
Mailing Address - Zip Code:53807-9804
Mailing Address - Country:US
Mailing Address - Phone:563-590-4459
Mailing Address - Fax:
Practice Address - Street 1:662 US-151 BUS
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818
Practice Address - Country:US
Practice Address - Phone:608-348-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6140-12111N00000X
WIPAR-0000145603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor