MEDICARE: HEALTH INCORPORATED OF MINNESOTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4667	MN

General Provider Information

NPI Number	:	1689721276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH INCORPORATED OF MINNESOTA

Provider Business Mailing Address
First Line	:	2817 LYNDALE AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2147
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2817 LYNDALE AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2147
Country	:	US
Telephone Number	:	612-612-8729
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSH HAGUE
Credential	:	D.C.
Telephone Number	:	651-228-9000

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	08/22/2020

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