MEDICARE: TWO RIVERS ACUPUNCTURE, YOGA AND SOUND HEALING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1033072996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWO RIVERS ACUPUNCTURE, YOGA AND SOUND HEALING LLC

Provider Business Mailing Address
First Line	:	7413 BOYD AVE
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55076-2411
Country	:	US
Telephone Number	:	952-465-6542
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 S ROBERT TRL STE 700
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55077-1443
Country	:	US
Telephone Number	:	952-465-6542
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	BRIAN GROSAM
Credential	:	PHD
Telephone Number	:	952-465-6542

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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