Provider Demographics
NPI:1417460817
Name:THE HEALTH ENHANCEMENT CENTERS, P.A.
Entity Type:Organization
Organization Name:THE HEALTH ENHANCEMENT CENTERS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:QUENTIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FIXEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:507-532-2655
Mailing Address - Street 1:6501 CITY WEST PKWY
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3248
Mailing Address - Country:US
Mailing Address - Phone:952-653-2565
Mailing Address - Fax:952-653-2540
Practice Address - Street 1:134 HWY 68
Practice Address - Street 2:
Practice Address - City:WABASSO
Practice Address - State:MN
Practice Address - Zip Code:56293
Practice Address - Country:US
Practice Address - Phone:952-653-2565
Practice Address - Fax:952-653-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN47560207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty