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General NPI Number Information
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NPI Number | 1073855953
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Entity Type | Organization
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Legal Business Name | PURE HEALTH, LLC
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Dates
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Enumeration Date | 03/19/2013
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 945 BROADWAY ST NE STE 275
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-2600
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Country | US
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Telephone | 612-345-8004
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Fax | 612-520-5121
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Provider Business Mailing Address
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Address Line | 945 BROADWAY ST NE STE 275
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-2600
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Country | US
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Telephone | 612-345-8004
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. DAVID GERARD MANCINI
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Credential | D.C.
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Telephone | 612-345-8004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4982
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License Number State | MN
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