Provider Demographics
NPI:1386973998
Name:PATZER, HILARY SIEGRIST (MAOM, LAC)
Entity type:Individual
Prefix:MS
First Name:HILARY
Middle Name:SIEGRIST
Last Name:PATZER
Suffix:
Gender:F
Credentials:MAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2157
Mailing Address - Country:US
Mailing Address - Phone:208-720-2570
Mailing Address - Fax:
Practice Address - Street 1:653 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-3401
Practice Address - Country:US
Practice Address - Phone:208-720-2570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1347171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist