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NPI Code Detail

MEDICARE: MICHAEL PATRICK EGAN L.AC.

MEDICARE:   MICHAEL PATRICK EGAN  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
1171100000XAcupuncturist1471MN

General Provider Information

NPI Number : 1982836243
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL PATRICK EGAN L.AC.
Provider Business Mailing Address
First Line : 2720 W 43RD ST STE 205
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55410-1643
Country : US
Telephone Number : 612-743-0397
Fax Number :
Provider Business Practice Location Address
First Line : 2720 W 43RD ST STE 205
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55410-1643
Country : US
Telephone Number : 612-743-0397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2009
Last Update Date : 12/15/2010

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Directions to “ MICHAEL PATRICK EGAN L.AC.” Practice Location

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