Provider Demographics
NPI:1740255686
Name:ENG, MARTIN O (DC)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:O
Last Name:ENG
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:710 DODGE AVENUE NW
Mailing Address - Street 2:SUITE C
Mailing Address - City:ELK RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:55330-2890
Mailing Address - Country:US
Mailing Address - Phone:763-441-1701
Mailing Address - Fax:763-441-5348
Practice Address - Street 1:710 DODGE AVENUE NW
Practice Address - Street 2:SUITE C
Practice Address - City:ELK RIVER
Practice Address - State:MN
Practice Address - Zip Code:55330-2890
Practice Address - Country:US
Practice Address - Phone:763-441-1701
Practice Address - Fax:763-441-5348
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2012-07-24
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Provider Licenses
StateLicense IDTaxonomies
MN3331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6855253-00Medicaid
MNU65098Medicare UPIN
MN6855253-00Medicaid