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General NPI Number Information
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NPI Number | 1003984477
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Entity Type | Organization
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Legal Business Name | HEALING SPIRIT CLINIC PLC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 714 S RUM RIVER DR
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City | PRINCETON
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State | MN
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Zip | 55371-2224
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Country | US
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Telephone | 763-633-4325
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Fax | 763-633-4326
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Provider Business Mailing Address
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Address Line | 714 S RUM RIVER DR
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City | PRINCETON
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State | MN
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Zip | 55371-2224
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Country | US
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Telephone | 763-633-4325
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Fax | 763-633-4326
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Authorized Official
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Title or Position | OWNER
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Name | HELLE EILEEN LUKK
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Credential | M.D.
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Telephone | 763-633-4325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | MN
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