Provider Demographics
NPI:1225334493
Name:WARREN INTERNAL HEALTH
Entity Type:Organization
Organization Name:WARREN INTERNAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:952-921-5858
Mailing Address - Street 1:3601 MINNESOTA DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5281
Mailing Address - Country:US
Mailing Address - Phone:952-921-5858
Mailing Address - Fax:952-921-5801
Practice Address - Street 1:3601 MINNESOTA DR
Practice Address - Street 2:SUITE 800
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5281
Practice Address - Country:US
Practice Address - Phone:952-921-5858
Practice Address - Fax:952-921-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5495111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty