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NPI 1942422720

NPI 1942422720 : PAMELA KAY JONES BFA,MS,D.O.M.,L.AC. : BLAINE, MN

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General NPI Number Information
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    NPI Number           |    1942422720
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    Entity Type          |    Individual 
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    Provider Name        |    PAMELA KAY JONES BFA,MS,D.O.M.,L.AC.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/03/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    12502 VAN BUREN ST NE 
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    City                 |    BLAINE
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    State                |    MN
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    Zip                  |    55434-3295
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    Country              |    US
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    Telephone            |    763-767-0410
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 480105 
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    City                 |    MINNEAPOLIS
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    State                |    MN
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    Zip                  |    55448-8105
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    Country              |    US
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    Telephone            |    763-767-0410
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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       |    1050
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    License Number State |    MN
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Taxonomy #2
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    Taxonomy Code        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    424
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    License Number State |    NM
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