MEDICARE: MR. GARY STEVEN COMPTON 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
1	171100000X	Acupuncturist	1294	MN

General Provider Information

NPI Number	:	1518136332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GARY STEVEN COMPTON L.AC.

Provider Business Mailing Address
First Line	:	3612 46TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2935
Country	:	US
Telephone Number	:	612-724-2214
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 S 8TH ST STE 1106
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-1222
Country	:	US
Telephone Number	:	612-347-6238
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	07/21/2022

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