Healthcare Provider Details

I. General information

NPI: 1083719116
Provider Name (Legal Business Name): CENTER FOR WELL BEING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 XERXES AVE S SUITE 300
BLOOMINGTON MN
55431-1253
US

IV. Provider business mailing address

7901 XERXES AVE S SUITE 300
BLOOMINGTON MN
55431-1253
US

V. Phone/Fax

Practice location:
  • Phone: 952-885-0822
  • Fax: 952-885-9180
Mailing address:
  • Phone: 952-885-0822
  • Fax: 952-885-9180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1758
License Number StateMN

VIII. Authorized Official

Name: DR. RICHARD L. MAYFIELD
Title or Position: PRESIDENT
Credential: D.C.
Phone: 952-885-0822