Healthcare Provider Details

I. General information

NPI: 1558208033
Provider Name (Legal Business Name): INTEGRATIVE ORTHOPEDIC CLINICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 FLYING CLOUD DR STE 100
EDEN PRAIRIE MN
55344-3320
US

IV. Provider business mailing address

6545 FLYING CLOUD DR STE 100
EDEN PRAIRIE MN
55344-3320
US

V. Phone/Fax

Practice location:
  • Phone: 952-941-3311
  • Fax: 942-944-2004
Mailing address:
  • Phone: 952-941-3311
  • Fax: 952-941-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD HILLS
Title or Position: OWNER
Credential: PT, DC FAAAOMPT
Phone: 952-941-3311