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General NPI Number Information
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NPI Number | 1922947506
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Entity Type | Organization
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Legal Business Name | TRUEFORM ELECTROLYSIS LLC
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 745 GRAND AVE STE 101
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City | SAINT PAUL
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State | MN
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Zip | 55105-3384
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Country | US
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Telephone | 651-666-9467
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Fax |
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Provider Business Mailing Address
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Address Line | 3426 OLIVER AVE N
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City | MINNEAPOLIS
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State | MN
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Zip | 55412-2320
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Country | US
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Telephone | 651-666-9467
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Fax |
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Authorized Official
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Title or Position | OWNER/ELECTROLOGIST
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Name | MS. JAMIE REY MOHLER
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Credential |
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Telephone | 651-666-9467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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