Provider Demographics
NPI:1669046892
Name:MARROW, JOSHUA (MAC, DIPLAC, LICA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:MARROW
Suffix:
Gender:M
Credentials:MAC, DIPLAC, LICA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-2433
Mailing Address - Country:US
Mailing Address - Phone:917-655-0200
Mailing Address - Fax:303-600-9991
Practice Address - Street 1:3137 HENNEPIN AVE STE 201
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2602
Practice Address - Country:US
Practice Address - Phone:917-655-0200
Practice Address - Fax:303-600-9991
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1658171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist