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General NPI Number Information
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NPI Number | 1295157113
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Entity Type | Organization
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Legal Business Name | MINNESOTA COMMUNITY ACUPUNCTURE-EDINA, INC.
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Dates
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Enumeration Date | 01/12/2014
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Last Update Date | 01/12/2014
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Provider Practice Location Address
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Address Line | 5500 LINCOLN DR STE 100
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City | EDINA
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State | MN
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Zip | 55436-1651
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Country | US
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Telephone | 952-746-3478
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Fax |
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Provider Business Mailing Address
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Address Line | 5500 LINCOLN DR STE 100
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City | EDINA
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State | MN
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Zip | 55436-1651
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Country | US
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Telephone | 952-746-3478
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Fax |
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | MRS. KERRI A CASEY
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Credential | L.AC.
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Telephone | 952-746-3478
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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 | 1388
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License Number State | MN
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