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Contact Information

LIFE CLINIC, P.A.
5525 CEDAR LAKE RD S
SAINT LOUIS PARK, MN55416-1420
 Phone: 651-690-0866
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

111NR0400X 35 Chiropractic
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for LIFE CLINIC, P.A.

NPI Number 1023296167
LBN Legal business name LIFE CLINIC, P.A.
Authorized official REZA ALIZADEH - (CHIROPRACTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/31/2008
Last updated 08/11/2014 - About 12 years ago
Identifiers
MN License # 3221
MN License # 8737
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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