Provider Demographics
NPI:1154899276
Name:SKYE ACUPUNCTURE LLC.
Entity type:Organization
Organization Name:SKYE ACUPUNCTURE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:952-994-8871
Mailing Address - Street 1:11124 DREW AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-3843
Mailing Address - Country:US
Mailing Address - Phone:952-994-8871
Mailing Address - Fax:
Practice Address - Street 1:2627 E FRANKLIN AVE STE 201
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1168
Practice Address - Country:US
Practice Address - Phone:952-994-8871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1184906042Medicaid