MEDICARE: MEAGHAN MOAKLEY

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

General Provider Information

NPI Number	:	1740854322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEAGHAN MOAKLEY

Provider Business Mailing Address
First Line	:	4388 FRANCE AVE S STE 260
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55410-1301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4388 FRANCE AVE S
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55410-1301
Country	:	US
Telephone Number	:	612-865-0182
Fax Number	:

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

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	10/27/2021

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Directions to “ MEAGHAN MOAKLEY ” Practice Location

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