Provider Demographics
NPI:1356677801
Name:THE FAMILY WELLNESS INSTITUTE, P. A.
Entity Type:Organization
Organization Name:THE FAMILY WELLNESS INSTITUTE, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-767-4680
Mailing Address - Street 1:4318 UPTON AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1555
Mailing Address - Country:US
Mailing Address - Phone:612-767-4680
Mailing Address - Fax:612-767-4686
Practice Address - Street 1:4318 UPTON AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-1555
Practice Address - Country:US
Practice Address - Phone:612-767-4680
Practice Address - Fax:612-767-4686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty