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Organization

INTEGRATED BODY THERAPIES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BARRY E WOLF MS (BILLING MANAGER)
(612) 867-2734
Entity
Organization

Contact information

Practice address
1901 FREDEEN RD, NEW BRIGHTON, MN 55112-2412
(651) 653-0786
(651) 762-7944
Mailing address
1901 FREDEEN RD, NEW BRIGHTON, MN 55112-2412
(651) 653-0786
(651) 762-7944

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA8782
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103503
ABMP
MN
01
7068-00
NCTMB
MN
Enumeration date
01/25/2013
Last updated
01/25/2013
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