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General NPI Number Information
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NPI Number | 1265614242
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Entity Type | Organization
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Legal Business Name | ADVACARE CLINICS,LTD
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 10/31/2014
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Provider Practice Location Address
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Address Line | 5001 AMERICAN BLVD W STE.945
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City | BLOOMINGTON
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State | MN
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Zip | 55437-1108
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Country | US
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Telephone | 952-835-6653
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Fax | 952-835-3895
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Provider Business Mailing Address
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Address Line | 5001 AMERICAN BLVD W STE.945
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City | BLOOMINGTON
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State | MN
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Zip | 55437-1108
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Country | US
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Telephone | 952-835-6653
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Fax | 952-835-3895
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Authorized Official
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Title or Position | CLINIC ADMINISTRATOR
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Name | MR. DENNIS JOHN LENSELINK
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Credential |
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Telephone | 952-835-6653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 401
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #7
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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 |
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Taxonomy #8
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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