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General NPI Number Information
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NPI Number | 1588256192
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Entity Type | Organization
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Legal Business Name | DUE NORTH CHIROPRACTIC LLC
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 6333 CAMBRIDGE ST STE 203
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-2453
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Country | US
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Telephone | 612-356-2858
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Fax |
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Provider Business Mailing Address
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Address Line | 3709 46TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-2912
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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 | OWNER
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Name | DR. AMANDA ANDERSON
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Credential | DC
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Telephone | 715-614-0198
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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 |
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License Number State |
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