Healthcare Provider Details

I. General information

NPI: 1225253628
Provider Name (Legal Business Name): MARGARET MARY MERTENS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 05/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S CHESTNUT AVE
MARSHFIELD WI
54449-2741
US

IV. Provider business mailing address

106 S CHESTNUT AVE
MARSHFIELD WI
54449-2741
US

V. Phone/Fax

Practice location:
  • Phone: 715-384-9064
  • Fax: 715-387-6954
Mailing address:
  • Phone: 715-384-9064
  • Fax: 715-387-6954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2195-012
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: