| NPI | 1548602097 |
|---|---|
| Doing Business As | INTEGRATED WELLNESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | SHANNON L BOLING Operations Office 612-483-9782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2018-04-30 |