Provider Demographics
NPI:1932899531
Name:BIRCHWOOD INTEGRATIVE CARE CLINIC, PLLC
Entity type:Organization
Organization Name:BIRCHWOOD INTEGRATIVE CARE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIER
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:651-444-8869
Mailing Address - Street 1:4590 SCOTT TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-4041
Mailing Address - Country:US
Mailing Address - Phone:651-444-8869
Mailing Address - Fax:
Practice Address - Street 1:4590 SCOTT TRL STE 100
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-4041
Practice Address - Country:US
Practice Address - Phone:651-444-8869
Practice Address - Fax:651-348-6107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty