MEDICARE: EASTWIND ACUPUNCTURE AND TUINA HEALING CENTER

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
1	171100000X	Acupuncturist	1085	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HP42639	OTHER	MN	HEALTHPARTNER

General Provider Information

NPI Number	:	1235308859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTWIND ACUPUNCTURE AND TUINA HEALING CENTER

Provider Business Mailing Address
First Line	:	3300 LYNDALE AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-3656
Country	:	US
Telephone Number	:	612-377-0080
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 LYNDALE AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-3656
Country	:	US
Telephone Number	:	612-377-0080
Fax Number	:

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	PROF. WEI LIU
Credential	:	L.AC.
Telephone Number	:	612-377-0080

Provider Enumeration Date	:	02/28/2008
Last Update Date	:	10/13/2011

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