Organization
UPLIFTED PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER HEIDE (OWNER)
(612) 208-8284
Entity
Organization
Contact information
Practice address
2136 FORD PKWY # 5476, SAINT PAUL, MN 55116-1863
(612) 208-8284
Mailing address
2136 FORD PKWY # 5476, SAINT PAUL, MN 55116-1863
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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