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NPI Code Detail

MEDICARE: MR. ANDREW ZACHARIAH STOCKMAN L. AC.

MEDICARE:  MR. ANDREW ZACHARIAH STOCKMAN  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
1171100000XAcupuncturist1460MN

General Provider Information

NPI Number : 1245463066
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW ZACHARIAH STOCKMAN L. AC.
Provider Business Mailing Address
First Line : 668 DULUTH ST
Second Line :
City : SAINT PAUL
State : MN
Zip : 55106-4710
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 150 CESAR CHAVEZ ST
Second Line :
City : SAINT PAUL
State : MN
Zip : 55107-2227
Country : US
Telephone Number : 651-209-8383
Fax Number : 612-728-0377
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2009
Last Update Date : 08/27/2009

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Directions to “ MR. ANDREW ZACHARIAH STOCKMAN L. AC.” Practice Location

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