Healthcare Provider Details

I. General information

NPI: 1750736559
Provider Name (Legal Business Name): RITUAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 LEXINGTON PKWY S
SAINT PAUL MN
55116-2350
US

IV. Provider business mailing address

780 LEXINGTON PKWY S
SAINT PAUL MN
55116-2350
US

V. Phone/Fax

Practice location:
  • Phone: 651-200-4091
  • Fax:
Mailing address:
  • Phone: 651-200-4091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1710
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTINA M HUCH
Title or Position: OWNER / LICENSED ACUPUNCTURIST
Credential: L.AC.
Phone: 651-200-4091