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NPI Code Detail

MEDICARE: CASSIE JO TRENHAILE L.AC.

MEDICARE: CASSIE JO TRENHAILE 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
1171100000XAcupuncturist1465MN

General Provider Information

NPI Number : 1669708046
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIE JO TRENHAILE L.AC.
Provider Business Mailing Address
First Line : 2724 GARFIELD AVE
Second Line : #1
City : MINNEAPOLIS
State : MN
Zip : 55408-1344
Country : US
Telephone Number : 612-790-5505
Fax Number :
Provider Business Practice Location Address
First Line : 1036 CLEVELAND AVE S
Second Line :
City : SAINT PAUL
State : MN
Zip : 55116-1826
Country : US
Telephone Number : 612-790-5505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2009
Last Update Date : 09/05/2012

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Directions to “ CASSIE JO TRENHAILE L.AC.” Practice Location

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