Organization
LIFE CLINIC OF PA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REZA ALIZADEH (OWNER/DC)
(952) 401-2336
Entity
Organization
Contact information
Practice address
700 E. SWEDESFORD RD., WAYNE, PA 19087
(952) 229-7464
Mailing address
PO BOX 549, CHANHASSEN, MN 55317-0549
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
05/08/2018
Last updated
07/11/2022
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