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Individual

PROF. TAO GONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.AC

Contact information

Practice address
6545 FRANCE AVE S # C-21, EDINA, MN 55435-2131
(952) 922-5000
(952) 922-5003
Mailing address
5717 KEMRICH DR, EDINA, MN 55439-1813
(952) 828-9888

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1348
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
63074
HEALTHPERTNAR PDR NUM
MN
Enumeration date
01/24/2007
Last updated
07/08/2007
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