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General NPI Number Information
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NPI Number | 1154560274
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Entity Type | Individual
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Provider Name | KYLIE BROOK SIMNIONIW D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 110 S CENTRAL AVE
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City | BEACH
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State | ND
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Zip | 58621-4001
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Country | US
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Telephone | 701-872-7520
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Fax | 701-872-7521
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Provider Business Mailing Address
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Address Line | 110 S CENTRAL AVE PO BOX 908
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City | BEACH
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State | ND
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Zip | 58621-4001
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Country | US
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Telephone | 701-872-7520
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Fax | 701-872-7521
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 835
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License Number State | ND
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