| Life Wellness Center, Inc. | |
|
10551 165th St W, Lakeville, MN 55044-5737 | |
| (952) 435-5300 | |
| (952) 898-1454 |
| Full Name | Life Wellness Center, Inc. |
|---|---|
| Type | Facility |
| Speciality | General Practice |
| Location | 10551 165th St W, Lakeville, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083646889 | NPI | - | NPPES |
| 025R4LI | Other | MN | BCBS GROUP ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Alfonso Morales-utrilla |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1407901499 PECOS PAC ID: 0446152094 Enrollment ID: I20040123000329 |
| Provider Name | Thomas M Schmidt |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1255349122 PECOS PAC ID: 3173574332 Enrollment ID: I20050204000360 |
| Provider Name | Shannon Jay Score |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1417976648 PECOS PAC ID: 3476560541 Enrollment ID: I20060314000658 |
| Provider Name | Christopher J Vandergriff |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033686258 PECOS PAC ID: 8224372933 Enrollment ID: I20181206003341 |
| Provider Name | Jenna L Coghlan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760039234 PECOS PAC ID: 6901136373 Enrollment ID: I20190927000253 |
| Provider Name | Kary Ann Barrette |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1275299505 PECOS PAC ID: 9335530385 Enrollment ID: I20211229001782 |
| Provider Name | Luke Thomas Schaefer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467915199 PECOS PAC ID: 7012246838 Enrollment ID: I20230809002436 |
| Provider Name | Sarah M Lewis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912089376 PECOS PAC ID: 5092801894 Enrollment ID: I20231127002026 |
| Provider Name | Sarah E Quinlan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285085688 PECOS PAC ID: 3678009321 Enrollment ID: I20250114001796 |
| Mailing Address | Practice Location Address |
|---|---|
| Life Wellness Center, Inc. 10551 165th St W, Lakeville, MN 55044-5737 Ph: (952) 435-5300 | Life Wellness Center, Inc. 10551 165th St W, Lakeville, MN 55044-5737 Ph: (952) 435-5300 |