Provider Demographics
NPI:1568797355
Name:TOSSELAND, RICHARD (LAC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:TOSSELAND
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W 2ND ST STE 308
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2646
Mailing Address - Country:US
Mailing Address - Phone:218-481-3243
Mailing Address - Fax:
Practice Address - Street 1:205 W 2ND ST STE 308
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2646
Practice Address - Country:US
Practice Address - Phone:218-481-3243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1039171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist