Organization
LIFE CLINIC, P.A.
Active
Organization
LIFE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REZA P ALIZADEH D.C. (CHIROPRACTOR)
(612) 868-6894
Entity
Organization
Contact information
Practice address
5525 CEDAR LAKE RD S, ST LOUIS PARK, MN 55416-1420
(651) 690-0866
Mailing address
33 HAMLINE AVE S, SAINT PAUL, MN 55105-2231
(651) 690-0866
(651) 690-0031
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
3221
MN
225100000X
Physical Therapist
8737
MN
Other
Enumeration date
01/31/2008
Last updated
08/11/2014
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