Provider Demographics
NPI:1508492117
Name:SHEN STUDIO, LLC
Entity Type:Organization
Organization Name:SHEN STUDIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, DOCTOR OF CHINESE MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUSE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DCM
Authorized Official - Phone:612-356-2562
Mailing Address - Street 1:505 1ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-4541
Mailing Address - Country:US
Mailing Address - Phone:612-356-2562
Mailing Address - Fax:
Practice Address - Street 1:505 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-4541
Practice Address - Country:US
Practice Address - Phone:612-356-2562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-15
Last Update Date:2020-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty