MEDICARE: MS. VICTORIA LEA HUITT 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
1	171100000X	Acupuncturist	1077	MN

General Provider Information

NPI Number	:	1851538508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICTORIA LEA HUITT L. AC.

Provider Business Mailing Address
First Line	:	3856 HARRIET AVE
Second Line	:	#3
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-1144
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6311 WAYZATA BLVD
Second Line	:	SUITE 210
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-1209
Country	:	US
Telephone Number	:	952-545-0200
Fax Number	:	952-545-6388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2009
Last Update Date	:	01/17/2009

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