Provider Demographics
NPI:1538460464
Name:VILIMPOC, SHAUYU (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:SHAUYU
Middle Name:
Last Name:VILIMPOC
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15239 DUPONT COURT
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5859
Mailing Address - Country:US
Mailing Address - Phone:612-408-0118
Mailing Address - Fax:
Practice Address - Street 1:7668 150TH ST W
Practice Address - Street 2:SUITE 203
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7102
Practice Address - Country:US
Practice Address - Phone:612-408-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1530171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist