Lifetime Wellness Center, P.a.

NPI 1265465934 - Chiropractor - 111N00000X

NPI Details
NPI 1265465934
Enumeration Date 07/08/2006
Last Updated 08/30/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JESSE C. JESSE
Position PRESIDENT
Phone (763) 559-5627
Fax
Practice Location
14215 44TH PL N
#6
PLYMOUTH MN, 55446-2344, US
Phone (763) 559-5627
Fax
Business Location
14215 44TH PL N
#6
PLYMOUTH MN, 55446-2344, US
Phone (763) 559-5627
Fax (763) 559-5627
Toxanomy
Taxonomy Code 111N00000X
License State Minnesota
License Number 4505
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According to our database, Lifetime Wellness Center, P.a. NPI is 1265465934, taxonomy code is 111N00000X and license number is 4505, license state is located at Minnesota. Lifetime Wellness Center, P.a. physically located at 14215 44th Pl N, Plymouth MN, 55446-2344. NPI Number 1033115704 has the healthcare provider type.

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1265465934 NPI number is provided on an as is basis without warranty of any kind. 1265465934 is maintained by the National Plan & Provider Enumeration System. The contents of Lifetime Wellness Center, P.a. are for informational purposes only.