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General NPI Number Information
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NPI Number | 1952629115
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Entity Type | Organization
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Legal Business Name | PAZIONG ACUPUNCTURE CLINIC OF WOODBURY
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 05/12/2010
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Provider Practice Location Address
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Address Line | 1520 WOODLANE DR
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City | WOODBURY
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State | MN
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Zip | 55125-2221
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Country | US
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Telephone | 651-210-9657
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 WOODLANE DR
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City | WOODBURY
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State | MN
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Zip | 55125-2221
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Country | US
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Telephone | 651-210-9657
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PAZIONG ESTELLE LO-VANG
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Credential | L.AC.
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Telephone | 651-214-5657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 1403
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License Number State | MN
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