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General NPI Number Information
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NPI Number | 1023988920
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Entity Type | Organization
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Legal Business Name | CK WELLNESS LLC
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 1400 VAN BUREN ST NE STE 200
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-3017
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Country | US
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Telephone | 612-800-8424
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Fax |
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Provider Business Mailing Address
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Address Line | 5744 11TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55417-2517
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Country | US
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Telephone | 608-963-3479
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARLEY ROLLINS
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Credential | MS, CNS, LN
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Telephone | 608-963-3479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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