| |
11550 Stillwater Blvd N Ste 101, Lake Elmo, MN 55042-8613 | |
(651) 323-0005 | |
(651) 927-0099 |
Full Name | |
---|---|
Type | Facility |
Speciality | Acupuncturist |
Location | 11550 Stillwater Blvd N Ste 101, Lake Elmo, Minnesota |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871738682 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
171100000X | Acupuncturist | AC01012 (Oregon) | Primary |
171100000X | Acupuncturist | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
---|---|
11550 Stillwater Blvd N Ste 101, Lake Elmo, MN 55042-8613 Ph: (651) 323-0005 | 11550 Stillwater Blvd N Ste 101, Lake Elmo, MN 55042-8613 Ph: (651) 323-0005 |