Provider Demographics
NPI:1063015253
Name:ARASEVI, MICHAL DANIEL (LAC)
Entity Type:Individual
Prefix:
First Name:MICHAL
Middle Name:DANIEL
Last Name:ARASEVI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:MICHAL
Other - Middle Name:DANIEL
Other - Last Name:KAZIMIERSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:18136 DUNBURY CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-7367
Mailing Address - Country:US
Mailing Address - Phone:651-808-0389
Mailing Address - Fax:
Practice Address - Street 1:3460 WASHINGTON DR STE 102
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-4301
Practice Address - Country:US
Practice Address - Phone:651-338-3574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN170111171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty