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General NPI Number Information
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NPI Number | 1518766880
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Entity Type | Individual
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Provider Name | YAN LU
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Gender | Male
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 1925 COUNTY ROAD B2 W STE 1-6
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City | ROSEVILLE
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State | MN
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Zip | 55113-2703
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Country | US
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Telephone | 651-631-0204
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 COUNTY ROAD F W APT 213
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City | SAINT PAUL
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State | MN
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Zip | 55112-2904
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Country | US
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Telephone | 612-229-8412
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Fax | 612-229-8412
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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 | 2103
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License Number State | MN
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