Provider Demographics
NPI:1184906042
Name:SILER, CASSIE S (LAC)
Entity type:Individual
Prefix:MS
First Name:CASSIE
Middle Name:S
Last Name:SILER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9920 GIRARD AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-3156
Mailing Address - Country:US
Mailing Address - Phone:952-994-8871
Mailing Address - Fax:
Practice Address - Street 1:9920 GIRARD AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-3156
Practice Address - Country:US
Practice Address - Phone:952-994-8871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1585171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist