MEDICARE: TARYN ANDERSON 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	1762	MN

General Provider Information

NPI Number	:	1871399659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARYN ANDERSON L.AC.

Provider Business Mailing Address
First Line	:	15226 W FREEWAY DR NE
Second Line	:
City	:	FOREST LAKE
State	:	MN
Zip	:	55025-9433
Country	:	US
Telephone Number	:	651-464-7111
Fax Number	:

Provider Business Practice Location Address
First Line	:	15226 W FREEWAY DR NE
Second Line	:
City	:	FOREST LAKE
State	:	MN
Zip	:	55025-9433
Country	:	US
Telephone Number	:	651-464-7111
Fax Number	:

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

Provider Enumeration Date	:	02/21/2025
Last Update Date	:	02/21/2025

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