Healthcare Provider Details

I. General information

NPI: 1942470927
Provider Name (Legal Business Name): HUA ZHU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 STATE ST N
WASECA MN
56093-2932
US

IV. Provider business mailing address

331 STATE ST N
WASECA MN
56093-2932
US

V. Phone/Fax

Practice location:
  • Phone: 507-835-1392
  • Fax:
Mailing address:
  • Phone: 507-835-1392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1105
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: