Provider Demographics
NPI:1942667829
Name:URBAN WELLNESS
Entity Type:Organization
Organization Name:URBAN WELLNESS
Other - Org Name:URBAN WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-590-0058
Mailing Address - Street 1:12100 SINGLETREE LANE #129
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344
Mailing Address - Country:US
Mailing Address - Phone:612-590-0058
Mailing Address - Fax:952-746-1392
Practice Address - Street 1:2309 W 50TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-2203
Practice Address - Country:US
Practice Address - Phone:612-590-0058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4134261QR0404X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities