Organization
PAIN RELIEF AND WELLNESS OF MINNESOTA
Active
Other names
Locketz Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM JASON LOCKETZ MD (OWNER/MD)
(651) 249-0454
Entity
Organization
Contact information
Practice address
4721 CLARK AVE, WHITE BEAR LAKE, MN 55110-3221
(651) 249-0454
(651) 560-7013
Mailing address
4721 CLARK AVE, WHITE BEAR LAKE, MN 55110-3221
(651) 788-6689
(651) 560-7013
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34536300
—
WI
05
—
530615900
—
MN
Enumeration date
04/11/2011
Last updated
02/13/2014
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