Provider Demographics
NPI:1700246600
Name:TWOMEY, JEAN E (LAC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:E
Last Name:TWOMEY
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 1:38400 DOVE ST
Mailing Address - Street 2:
Mailing Address - City:AITKIN
Mailing Address - State:MN
Mailing Address - Zip Code:56431-2191
Mailing Address - Country:US
Mailing Address - Phone:218-670-0599
Mailing Address - Fax:
Practice Address - Street 1:38400 DOVE ST
Practice Address - Street 2:
Practice Address - City:AITKIN
Practice Address - State:MN
Practice Address - Zip Code:56431-2191
Practice Address - Country:US
Practice Address - Phone:218-670-0599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1769171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist