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General NPI Number Information
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NPI Number | 1689965899
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Entity Type | Organization
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Legal Business Name | HANDS ON HEART HOLISTIC HEALTHCARE, P.A.
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/25/2011
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Provider Practice Location Address
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Address Line | 821 RAYMOND AVE STE 110 110
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City | SAINT PAUL
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State | MN
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Zip | 55114-1538
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Country | US
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Telephone | 665-169-0554
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Fax |
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Provider Business Mailing Address
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Address Line | 821 RAYMOND AVE STE 110 110
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City | SAINT PAUL
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State | MN
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Zip | 55114-1538
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Country | US
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Telephone | 665-169-0554
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAURA MARIE MUDRAK
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Credential | D.C.
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Telephone | 651-690-5543
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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 |
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License Number State |
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