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General NPI Number Information
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NPI Number | 1518786698
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Entity Type | Organization
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Legal Business Name | ONE SOURCE CARE LLC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 1972 W 5400 S
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City | TAYLORSVILLE
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State | UT
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Zip | 84129-1459
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Country | US
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Telephone | 385-497-5590
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Fax | 888-622-9950
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Provider Business Mailing Address
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Address Line | 1704 S STATE ST
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City | OREM
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State | UT
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Zip | 84097-8011
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Country | US
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Telephone | 385-497-5590
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Fax | 888-622-9950
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL LAFONTAINE
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Credential | DC
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Telephone | 385-252-8777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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