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General NPI Number Information
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NPI Number | 1467320333
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Entity Type | Individual
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Provider Name | TA LINDA CHANG LAC
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Gender | Female
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 2233 HAMLINE AVE N STE 432
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City | ROSEVILLE
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State | MN
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Zip | 55113-5006
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Country | US
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Telephone | 651-402-6777
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Fax |
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Provider Business Mailing Address
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Address Line | 1711 SHERWOOD AVE
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City | SAINT PAUL
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State | MN
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Zip | 55106-2216
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Country | US
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Telephone | 651-402-6777
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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 | 2089-55
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 2119
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License Number State | MN
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