Healthcare Provider Details

I. General information

NPI: 1669634879
Provider Name (Legal Business Name): YING-TZU HSU L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2008
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2578 RICE ST.
LITTLE CANADA MN
55113-3712
US

IV. Provider business mailing address

2578 RICE ST.
LITTLE CANADA MN
55113-3712
US

V. Phone/Fax

Practice location:
  • Phone: 651-999-9150
  • Fax:
Mailing address:
  • Phone: 651-999-9150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1445
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: