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NPI Code Detail

MEDICARE: ALEXIS RAE HILEMAN M.OM., L.AC

MEDICARE:   ALEXIS RAE HILEMAN  M.OM., L.AC
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
1171100000XAcupuncturist1833MN

General Provider Information

NPI Number : 1215449640
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS RAE HILEMAN M.OM., L.AC
Provider Business Mailing Address
First Line : 12308 PARKWOOD PL
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-6862
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2627 E FRANKLIN AVE STE 201
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-1168
Country : US
Telephone Number : 612-870-1500
Fax Number : 612-870-1551
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2017
Last Update Date : 10/25/2017

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