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General NPI Number Information
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NPI Number | 1932657590
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Entity Type | Organization
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Legal Business Name | AITKIN ACUPUNCTURE LLC
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 601 BUNKER HILL DR
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City | AITKIN
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State | MN
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Zip | 56431-1864
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Country | US
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Telephone | 218-670-0599
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Fax | 218-216-8986
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Provider Business Mailing Address
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Address Line | 38400 DOVE ST
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City | AITKIN
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State | MN
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Zip | 56431-2191
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Country | US
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Telephone | 218-670-0599
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Fax |
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Authorized Official
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Title or Position | OWNER AND LICENSED ACUPUNCTURIST
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Name | JEAN E TWOMEY
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Credential | L.AC.
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Telephone | 218-670-0599
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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 | 1769
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License Number State | MN
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