Organization
EAST WEST CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. COLET STELLA LAHOZ L.AC. RN (OWNER)
(651) 429-9595
Entity
Organization
Contact information
Practice address
5770 W BALD EAGLE BLVD, WHITE BEAR LAKE, MN 55110-6440
(651) 429-9595
(651) 429-9595
Mailing address
5770 W BALD EAGLE BLVD, WHITE BEAR LAKE, MN 55110-6440
(651) 429-9595
(651) 429-9595
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1013
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24137JE
BCBS GROUP NUMBER
MN
01
—
55054
HP GROUP NUMBER
MN
Enumeration date
11/29/2006
Last updated
06/12/2008
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