Healthcare Provider Details

I. General information

NPI: 1346311123
Provider Name (Legal Business Name): ZHUOLING REN L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 GRAND AVE
SAINT PAUL MN
55105-3019
US

IV. Provider business mailing address

1033 GRAND AVE
SAINT PAUL MN
55105-3019
US

V. Phone/Fax

Practice location:
  • Phone: 651-222-1200
  • Fax: 651-312-1464
Mailing address:
  • Phone: 651-222-1200
  • Fax: 651-312-1464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1072
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: