Provider Demographics
NPI:1487371746
Name:WINTER, JULIET ELIZABETH (LAC)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:ELIZABETH
Last Name:WINTER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3124 EDGEWOOD AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55426-3423
Mailing Address - Country:US
Mailing Address - Phone:612-670-6266
Mailing Address - Fax:
Practice Address - Street 1:2 DIVISION ST E STE 103
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:MN
Practice Address - Zip Code:55313-1774
Practice Address - Country:US
Practice Address - Phone:763-220-0623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2010171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist