Healthcare Provider Details

I. General information

NPI: 1427553726
Provider Name (Legal Business Name): IMPROVED HEALTH THERAPEUTIC MASSAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5009 EXCELSIOR BLVD STE 141
ST LOUIS PARK MN
55416-3035
US

IV. Provider business mailing address

5009 EXCELSIOR BLVD STE 141
ST LOUIS PARK MN
55416-3035
US

V. Phone/Fax

Practice location:
  • Phone: 952-255-9399
  • Fax:
Mailing address:
  • Phone: 952-255-9399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number00042881
License Number StateMN

VIII. Authorized Official

Name: DANICA KRIZIC
Title or Position: MASSAGE THERAPIST/OWNER
Credential: MASSAGE THERAPIST
Phone: 952-255-9399