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General NPI Number Information
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NPI Number | 1538891031
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Entity Type | Individual
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Provider Name | BARRY J CARNAHAN DACCHM, L.AC.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2022
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 7650 CURRELL BLVD STE 255A
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City | WOODBURY
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State | MN
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Zip | 55125-2257
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Country | US
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Telephone | 651-788-0563
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Fax |
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Provider Business Mailing Address
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Address Line | 600 SHERWOOD RD
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City | SHOREVIEW
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State | MN
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Zip | 55126-4765
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Country | US
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Telephone | 651-788-0563
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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 | 1970
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License Number State | MN
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