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NPI Code Detail

MEDICARE: SARAH ANN LARSON L.AC.

MEDICARE: SARAH ANN LARSON L.AC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist1390MN

General Provider Information

NPI Number : 1205055134
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ANN LARSON L.AC.
Provider Business Mailing Address
First Line : 5309 40TH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-2225
Country : US
Telephone Number : 952-994-2828
Fax Number :
Provider Business Practice Location Address
First Line : 730 CLEVELAND AVE S
Second Line :
City : SAINT PAUL
State : MN
Zip : 55116-1345
Country : US
Telephone Number : 651-699-8610
Fax Number : 651-699-1207
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 07/08/2007

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Directions to “ SARAH ANN LARSON L.AC.” Practice Location

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