Provider Demographics
NPI:1578097754
Name:US HEALTH CLINIC PLLC
Entity Type:Organization
Organization Name:US HEALTH CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-600-6525
Mailing Address - Street 1:8053 E BLOOMINGTON FWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-4577
Mailing Address - Country:US
Mailing Address - Phone:651-600-6525
Mailing Address - Fax:
Practice Address - Street 1:8053 E BLOOMINGTON FWY
Practice Address - Street 2:SUITE 450
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-4577
Practice Address - Country:US
Practice Address - Phone:651-600-6525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1995261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty