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General NPI Number Information
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NPI Number | 1477817666
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Entity Type | Organization
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Legal Business Name | CIRCLE SAGE HEALING INC.
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 10 MCANDREWS RD E
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City | BURNSVILLE
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State | MN
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Zip | 55337-5718
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Country | US
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Telephone | 952-435-3556
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Fax | 952-435-0905
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Provider Business Mailing Address
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Address Line | 10 MCANDREWS RD E
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City | BURNSVILLE
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State | MN
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Zip | 55337-5718
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Country | US
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Telephone | 952-435-3556
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Fax | 952-435-0905
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Authorized Official
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Title or Position | OWNER/MASSAGE THERAPIST
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Name | MAUREEN QUEAU
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Credential |
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Telephone | 952-435-3556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | TM-2869
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License Number State | MN
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