NPIMap

Organization Active NPI

Dynamic Health Clinic, LLC

  • Acupuncturist
  • Saint Louis Park, MN
National Provider Identifier
1639446974
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1517 Issued in MN
Legal business name
DYNAMIC HEALTH CLINIC, LLC
Practice address
6121 Excelsior Blvd
Suite 205
Saint Louis Park, MN 55416-2725
Phone
(612) 710-7415
NPI assigned
Nov 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Joseph Bickle, L.AC.NPI 1922381169
Title
Owner/Operator
Phone
(612) 710-7415

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X 1517 MN Primary

Addresses

Primary practice location

6121 Excelsior Blvd
Suite 205
Saint Louis Park, MN 55416-2725

Mailing address

6121 Excelsior Blvd
Suite 205
Saint Louis Park, MN 55416-2725
Phone (612) 710-7415

National Provider Directory

National Provider Directory

Locations

6121 Excelsior Blvd
Ste 205
Saint Louis Park, MN 55416
Phone (612) 710-7415

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1639446974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 EXCELSIOR BLVD",
            "address_2": "SUITE 205",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162725",
            "telephone_number": "612-710-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 EXCELSIOR BLVD",
            "address_2": "SUITE 205",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162725",
            "telephone_number": "612-710-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "BICKLE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "612-710-7415",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "1517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.