Healthcare Provider Details

I. General information

NPI: 1184055063
Provider Name (Legal Business Name): SAGE CENTRE FOR NATURAL MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 SAINT CLAIR AVE
SAINT PAUL MN
55105-1642
US

IV. Provider business mailing address

234 WHITE PINE RD
LINO LAKES MN
55014-5450
US

V. Phone/Fax

Practice location:
  • Phone: 612-816-8044
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number2006
License Number StateOR

VIII. Authorized Official

Name: DR. JENNIFER MARIE KRIEGER
Title or Position: OWNER
Credential: N.D.
Phone: 612-816-8044