Provider Demographics
NPI:1457629685
Name:EN MOTION WELLNESS, LLC
Entity Type:Organization
Organization Name:EN MOTION WELLNESS, LLC
Other - Org Name:HEALING HANDS WELLNESS CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MANAGER OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CLARENCE
Authorized Official - Last Name:SLATER
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:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116
Mailing Address - Country:US
Mailing Address - Phone:651-699-3366
Mailing Address - Fax:651-699-5780
Practice Address - Street 1:1036 CLEVELAND AVE S
Practice Address - Street 2:
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116
Practice Address - Country:US
Practice Address - Phone:651-699-3366
Practice Address - Fax:651-699-5780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1116111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty