Healthcare Provider Details

I. General information

NPI: 1427371905
Provider Name (Legal Business Name): VILLAGE ACUPUNCTURE AND MASSAGE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2010
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 CLEVELAND AVE S
SAINT PAUL MN
55116-1345
US

IV. Provider business mailing address

730 CLEVELAND AVE S
SAINT PAUL MN
55116-1345
US

V. Phone/Fax

Practice location:
  • Phone: 651-699-8610
  • Fax: 651-699-1207
Mailing address:
  • Phone: 651-699-8610
  • Fax: 651-699-1207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MISS ANNE LANGFORD
Title or Position: PRESIDENT
Credential: DC, DICCP
Phone: 651-699-8610