Provider Demographics
NPI:1699399485
Name:HEALINGTREE INTEGRATIVE HEALTH CLINIC, PLLC
Entity Type:Organization
Organization Name:HEALINGTREE INTEGRATIVE HEALTH CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-520-1601
Mailing Address - Street 1:2520 S WASHINGTON ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6777
Mailing Address - Country:US
Mailing Address - Phone:701-757-4325
Mailing Address - Fax:
Practice Address - Street 1:2520 S WASHINGTON ST UNIT B
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6777
Practice Address - Country:US
Practice Address - Phone:701-757-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty