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General NPI Number Information
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NPI Number | 1942667829
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Entity Type | Organization
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Legal Business Name | URBAN WELLNESS
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Dates
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Enumeration Date | 01/22/2016
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Last Update Date | 01/22/2016
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Provider Practice Location Address
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Address Line | 2309 W 50TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55410-2203
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Country | US
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Telephone | 612-590-0058
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Fax |
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Provider Business Mailing Address
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Address Line | 12100 SINGLETREE LANE #129
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344
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Country | US
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Telephone | 612-590-0058
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Fax | 952-746-1392
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AARON KIRKING
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Credential | D.C.
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Telephone | 612-590-0058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0404X
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Taxonomy Name | Cardiac Rehabilitation Clinic/Center
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License Number | 4134
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License Number State | MN
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