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General NPI Number Information
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NPI Number | 1033072996
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Entity Type | Organization
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Legal Business Name | TWO RIVERS ACUPUNCTURE, YOGA AND SOUND HEALING LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 5300 S ROBERT TRL STE 700
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55077-1443
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Country | US
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Telephone | 952-465-6542
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Fax |
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Provider Business Mailing Address
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Address Line | 7413 BOYD AVE
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-2411
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Country | US
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Telephone | 952-465-6542
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | BRIAN GROSAM
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Credential | PHD
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Telephone | 952-465-6542
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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 |
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License Number State |
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