Organization
LIFE CLINIC OF VA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REZA ALIZADEH (OWNER)
(952) 229-7464
Entity
Organization
Contact information
Practice address
7801 LIMESTONE DR, GAINESVILLE, VA 20155-4050
(952) 229-7464
Mailing address
PO BOX 549, CHANHASSEN, MN 55317-0549
(952) 229-7464
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
01/31/2019
Last updated
02/01/2019
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