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General NPI Number Information
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NPI Number | 1396765285
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Entity Type | Individual
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Provider Name | DANIEL RAY OLSON D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 2400 COUNTY ROAD D W
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City | SAINT PAUL
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State | MN
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Zip | 55112-7564
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Country | US
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Telephone | 651-633-0155
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Fax | 651-604-2935
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Provider Business Mailing Address
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Address Line | 2400 COUNTY ROAD D W #101
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City | SAINT PAUL
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State | MN
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Zip | 55112-7564
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Country | US
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Telephone | 651-633-0155
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Fax | 651-604-2935
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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 | 4556
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License Number State | MN
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