Life Wellness Center, Inc. | |
10551 165th St W, Lakeville, MN 55044-5737 | |
(952) 435-5300 | |
(952) 898-1454 |
Full Name | Life Wellness Center, Inc. |
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Type | Facility |
Speciality | General Practice |
Location | 10551 165th St W, Lakeville, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083646889 | NPI | - | NPPES |
025R4LI | Other | MN | BCBS GROUP ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
Provider Name | Alfonso Morales-utrilla |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1407901499 PECOS PAC ID: 0446152094 Enrollment ID: I20040123000329 |
Provider Name | Thomas M Schmidt |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1255349122 PECOS PAC ID: 3173574332 Enrollment ID: I20050204000360 |
Provider Name | Shannon Jay Score |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1417976648 PECOS PAC ID: 3476560541 Enrollment ID: I20060314000658 |
Provider Name | Kyle D Traynor |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1760712087 PECOS PAC ID: 8628105343 Enrollment ID: I20100428000459 |
Provider Name | Christopher J Vandergriff |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1033686258 PECOS PAC ID: 8224372933 Enrollment ID: I20181206003341 |
Provider Name | Jenna L Coghlan |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1760039234 PECOS PAC ID: 6901136373 Enrollment ID: I20190927000253 |
Provider Name | Kary Ann Barrette |
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Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1275299505 PECOS PAC ID: 9335530385 Enrollment ID: I20211229001782 |
Provider Name | Luke Schaefer |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1467915199 PECOS PAC ID: 7012246838 Enrollment ID: I20230809002436 |
Provider Name | Sarah M Lewis |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1912089376 PECOS PAC ID: 5092801894 Enrollment ID: I20231127002026 |
Mailing Address | Practice Location Address |
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Life Wellness Center, Inc. 10551 165th St W, Lakeville, MN 55044-5737 Ph: (952) 435-5300 | Life Wellness Center, Inc. 10551 165th St W, Lakeville, MN 55044-5737 Ph: (952) 435-5300 |