| Kinetic Wellness, Llc | |
|
614 Hawthorne St Ste 2 Alexandria MN 56308-1662 | |
| (320) 491-1892 | |
| Not Available |
| Full Name | Kinetic Wellness, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 614 Hawthorne St Ste 2, Alexandria, Minnesota |
| Authorized Official Name and Position | Ronna Severson (OWNER) |
| Authorized Official Contact | 3204911892 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kinetic Wellness, Llc Po Box 133 Carlos MN 56319-0133 Ph: (320) 491-1892 | Kinetic Wellness, Llc 614 Hawthorne St Ste 2 Alexandria MN 56308-1662 Ph: (320) 491-1892 |
| NPI Number | 1598350092 |
|---|---|
| Provider Enumeration Date | 03/05/2021 |
| Last Update Date | 03/05/2021 |
| Certification Date | 03/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598350092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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