Provider Demographics
NPI:1528404142
Name:LAND HEALTH & WELLNESS
Entity Type:Organization
Organization Name:LAND HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-462-6803
Mailing Address - Street 1:6001 EGAN DR
Mailing Address - Street 2:#140
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-4921
Mailing Address - Country:US
Mailing Address - Phone:612-462-6803
Mailing Address - Fax:
Practice Address - Street 1:6001 EGAN DR
Practice Address - Street 2:#140
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-4921
Practice Address - Country:US
Practice Address - Phone:612-462-6803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty