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General NPI Number Information
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NPI Number | 1447285655
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Entity Type | Individual
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Provider Name | THOMAS J BALFANZ MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 4801 VETERANS DR
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City | SAINT CLOUD
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State | MN
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Zip | 56303-2099
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Country | US
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Telephone | 320-252-1670
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Fax | 320-255-6327
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Provider Business Mailing Address
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Address Line | 8170 33RD AVE S MS 21110Q
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City | BLOOMINGTON
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State | MN
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Zip | 55425
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Country | US
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Telephone |
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 33476
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License Number State | MN
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