Individual
SHANE B BERQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L. AC., M.SC.O.M.
Contact information
Practice address
1829 RIVERSIDE AVE STE 200, MINNEAPOLIS, MN 55454-1037
(651) 353-8031
Mailing address
1829 RIVERSIDE AVE STE 200, MINNEAPOLIS, MN 55454-1037
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1659
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134468093
—
MN
Enumeration date
02/12/2013
Last updated
12/03/2020
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