Wildwood Wellness Llc | |
744 Wildwood Rd, Mahtomedi, MN 55115-1852 | |
(651) 300-4377 | |
Not Available |
Full Name | Wildwood Wellness Llc |
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Type | Facility |
Speciality | Chiropractor |
Location | 744 Wildwood Rd, Mahtomedi, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1730816661 | NPI | - | NPPES |
1538758479 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Joshua J Hague |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1558375451 PECOS PAC ID: 2668491036 Enrollment ID: I20051115000412 |
Mailing Address | Practice Location Address |
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Wildwood Wellness Llc 312 Warner Ave S, Willernie, MN 55090-7702 Ph: (651) 249-5170 | Wildwood Wellness Llc 744 Wildwood Rd, Mahtomedi, MN 55115-1852 Ph: (651) 300-4377 |
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