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NPI Code Detail

MEDICARE: ALEX GUILLIEN

MEDICARE: ALEX GUILLIEN
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
1225700000XMassage Therapist

General Provider Information

NPI Number : 1568006005
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX GUILLIEN
Provider Business Mailing Address
First Line : 34 13TH AVE NE STE 109
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1007
Country : US
Telephone Number : 612-378-1050
Fax Number : 612-378-1051
Provider Business Practice Location Address
First Line : 34 13TH AVE NE STE 109
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55413-1007
Country : US
Telephone Number : 612-378-1050
Fax Number : 612-378-1051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2019
Last Update Date : 10/28/2019

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Directions to “ ALEX GUILLIEN ” Practice Location

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