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General NPI Number Information
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NPI Number | 1841538808
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Entity Type | Organization
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Legal Business Name | WHITE DANDELION CHINESE MEDICINE L.L.C.
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Dates
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Enumeration Date | 01/27/2013
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Last Update Date | 01/27/2013
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Provider Practice Location Address
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Address Line | 108 3RD ST E
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City | NORTHFIELD
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State | MN
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Zip | 55057-2050
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Country | US
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Telephone | 507-222-0746
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Fax |
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Provider Business Mailing Address
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Address Line | 307 WOODLEY ST W
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City | NORTHFIELD
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State | MN
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Zip | 55057-2741
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Country | US
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Telephone | 507-301-6565
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Fax |
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | MRS. MIKA ELIZABETH TURNER
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Credential | L. AC.
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Telephone | 507-301-6565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 1597
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License Number State | MN
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