| Purepath Healing Services LLC | |
|
202 Jean Ave N Lake Elmo MN 55042-5516 | |
| (612) 456-2069 | |
| Not Available |
| Full Name | Purepath Healing Services LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 202 Jean Ave N, Lake Elmo, Minnesota |
| Authorized Official Name and Position | Luqman Ibrahim (OWNER) |
| Authorized Official Contact | 6124562069 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purepath Healing Services LLC 202 Jean Ave N Lake Elmo MN 55042-5516 | Purepath Healing Services LLC 202 Jean Ave N Lake Elmo MN 55042-5516 Ph: (612) 456-2069 |
| NPI Number | 1457176729 |
|---|---|
| Provider Enumeration Date | 11/20/2024 |
| Last Update Date | 11/20/2024 |
| Certification Date | 11/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457176729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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