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NPI 1003365727

NPI 1003365727 : WARREN KING L.AC. : MINNETONKA, MN

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General NPI Number Information
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    NPI Number           |    1003365727
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    Entity Type          |    Individual 
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    Provider Name        |    WARREN KING L.AC.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/22/2016
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    Last Update Date     |    09/22/2016
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Provider Practice Location Address
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    Address Line         |    15612 HIGHWAY 7 SUITE 252
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    City                 |    MINNETONKA
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    State                |    MN
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    Zip                  |    55345-3543
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    Country              |    US
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    Telephone            |    952-930-3575
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    15612 HIGHWAY 7 SUITE 252
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    City                 |    MINNETONKA
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    State                |    MN
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    Zip                  |    55345-3543
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    Country              |    US
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    Telephone            |    952-930-3575
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    1065
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    License Number State |    MN
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