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General NPI Number Information
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NPI Number | 1235941212
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Entity Type | Organization
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Legal Business Name | ORCHARD ACUPUNCTURE
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 821 RAYMOND AVE STE 130-E
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City | SAINT PAUL
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State | MN
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Zip | 55114-1503
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Country | US
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Telephone | 718-288-3162
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Fax |
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Provider Business Mailing Address
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Address Line | 1438 LAFOND AVENUE
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City | SAINT PAUL
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State | MN
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Zip | 55104
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Country | US
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Telephone | 718-288-3162
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Fax |
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURIST
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Name | KELLY E SMITH
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Credential | M.S, L.AC.
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Telephone | 718-288-3162
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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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