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NPI Code Detail

MEDICARE: MR. STEPHEN P BIALON L.AC

MEDICARE: MR. STEPHEN P BIALON 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
1171100000XAcupuncturist1441MN

General Provider Information

NPI Number : 1225339567
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN P BIALON L.AC
Provider Business Mailing Address
First Line : 2627 E. FRANKLIN AVE SUITE #201
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406
Country : US
Telephone Number : 612-730-4336
Fax Number :
Provider Business Practice Location Address
First Line : 2627 E FRANKLIN AVE STE 201
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-1168
Country : US
Telephone Number : 612-730-4336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2010
Last Update Date : 11/03/2010

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