Individual
MOLLY JEWELL O'BRIEN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5009 EXCELSIOR BLVD STE 110, ST LOUIS PARK, MN 55416-3039
(612) 669-4758
Mailing address
4248 VINCENT AVE S, MINNEAPOLIS, MN 55410-1519
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1971
MN
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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