MEDICARE: KATHERINE KRUMWIEDE 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	1340	MN

General Provider Information

NPI Number	:	1982787875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE KRUMWIEDE L.AC.

Provider Business Mailing Address
First Line	:	2415 HENNEPIN AVE. S.
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2605
Country	:	US
Telephone Number	:	612-872-9133
Fax Number	:	612-872-0342

Provider Business Practice Location Address
First Line	:	2415 HENNEPIN AVE. S.
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2605
Country	:	US
Telephone Number	:	612-872-9133
Fax Number	:	612-872-0342

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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