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General NPI Number Information
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NPI Number | 1417460817
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Entity Type | Organization
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Legal Business Name | THE HEALTH ENHANCEMENT CENTERS, P.A.
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 11/08/2017
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Provider Practice Location Address
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Address Line | 134 HWY 68
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City | WABASSO
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State | MN
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Zip | 56293
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Country | US
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Telephone | 952-653-2565
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Fax | 952-653-2540
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Provider Business Mailing Address
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Address Line | 6501 CITY WEST PKWY
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-3248
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Country | US
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Telephone | 952-653-2565
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Fax | 952-653-2540
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Authorized Official
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Title or Position | CEO
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Name | QUENTIN JAMES FIXEN
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Credential | DC
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Telephone | 507-532-2655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 47560
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License Number State | MN
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