Provider Demographics
NPI:1770355760
Name:FAMILY TREE ACUPUNCTURE
Entity type:Organization
Organization Name:FAMILY TREE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENIEK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:612-805-8131
Mailing Address - Street 1:4748 CHICAGO AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-4320
Mailing Address - Country:US
Mailing Address - Phone:612-805-8131
Mailing Address - Fax:
Practice Address - Street 1:4748 CHICAGO AVE STE 21
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-4320
Practice Address - Country:US
Practice Address - Phone:612-805-8131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty