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Contact Information

LIFECLINIC PA
5525 CEDAR LAKE RD S
SAINT LOUIS PARK, MN55416-1420
 Phone: 952-229-7901
 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 LIFECLINIC PA

NPI # 1922416064
LBN Legal business name LIFECLINIC PA
Authorized official REZA ALIZADEH - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 07/31/2014
Last updated 07/31/2014 - About 12 years ago
Identifiers
MN License # 3112
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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