Provider Demographics
NPI:1306021258
Name:HEALING HANDS WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:HEALING HANDS WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:STARBUCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:651-699-3366
Mailing Address - Street 1:1036 CLEVELAND AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1826
Mailing Address - Country:US
Mailing Address - Phone:651-699-3366
Mailing Address - Fax:
Practice Address - Street 1:1036 CLEVELAND AVE S
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-1826
Practice Address - Country:US
Practice Address - Phone:651-699-3366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4864111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN381L7JUOtherBCBS CLINIC ID
MN637649500Medicaid
MN637649500Medicaid