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General NPI Number Information
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NPI Number | 1972290286
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Entity Type | Organization
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Legal Business Name | NEW LEAF ACUPUNCTURE
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 21830 OLINDA LN N
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City | SCANDIA
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State | MN
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Zip | 55073-9702
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Country | US
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Telephone | 651-270-6140
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Fax |
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Provider Business Mailing Address
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Address Line | 21830 OLINDA LN N
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City | SCANDIA
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State | MN
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Zip | 55073-9702
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Country | US
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Telephone | 651-270-6140
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | DAWN M PIVEC
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Credential |
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Telephone | 651-270-6140
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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 |
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License Number State |
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