Provider Demographics
NPI:1225855067
Name:HOERTER, JULIA LAUREN (LAC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:LAUREN
Last Name:HOERTER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3546 DAKOTA AVE S STE B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2331
Mailing Address - Country:US
Mailing Address - Phone:952-417-6433
Mailing Address - Fax:
Practice Address - Street 1:3546 DAKOTA AVE S STE B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2331
Practice Address - Country:US
Practice Address - Phone:952-417-6433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2059171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist