Provider Demographics
NPI:1598334815
Name:MODERN POINT ACUPUNCTURE
Entity Type:Organization
Organization Name:MODERN POINT ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:763-494-9500
Mailing Address - Street 1:2810 29TH ST UNIT A201
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1243
Mailing Address - Country:US
Mailing Address - Phone:763-494-9500
Mailing Address - Fax:
Practice Address - Street 1:9325 UPLAND LN N STE 240
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4486
Practice Address - Country:US
Practice Address - Phone:763-494-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1295129906OtherNPI