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General NPI Number Information
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NPI Number | 1750744439
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Entity Type | Individual
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Provider Name | LAUREN SHELDON LAC
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Gender | Female
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Dates
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Enumeration Date | 03/31/2016
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 217 PLUM ST STE 120
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City | RED WING
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State | MN
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Zip | 55066-2340
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Country | US
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Telephone | 651-300-6119
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Fax |
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Provider Business Mailing Address
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Address Line | W4179 490TH AVE
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City | ELLSWORTH
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State | WI
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Zip | 54011-5822
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Country | US
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Telephone | 715-307-8877
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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 | 1799
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License Number State | MN
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