Organization
1 BODY HEALTH AND FITNESS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN NELSON (CEO)
(218) 253-2111
Entity
Organization
Contact information
Practice address
105 INTERNATIONAL DR, SUITE 121, RED LAKE FALLS, MN 56750-4665
(218) 253-2111
Mailing address
105 INTERNATIONAL DR, SUITE 121, RED LAKE FALLS, MN 56750-4665
(218) 253-2111
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3008
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4K044TH
BLUE CROSS
MN
01
—
822797011671
PREFERRED ONE
MN
Enumeration date
06/13/2008
Last updated
12/16/2016
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