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General NPI Number Information
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NPI Number | 1194900936
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Entity Type | Organization
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Legal Business Name | VALKOS CHIROPRACTIC OFFICE, LLC
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 106 S WASHINGTON ST
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City | LAKE CITY
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State | MN
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Zip | 55041-1034
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Country | US
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Telephone | 651-345-2785
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Fax | 651-345-5321
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Provider Business Mailing Address
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Address Line | 106 S WASHINGTON ST
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City | LAKE CITY
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State | MN
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Zip | 55041-1034
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Country | US
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Telephone | 651-345-2785
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Fax | 651-345-5321
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Authorized Official
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Title or Position | CHIROPRACTOR/ OWNER
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Name | DR. DAVID VALKOS
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Credential | D.C.
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Telephone | 651-345-2785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 002300
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License Number State | MN
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