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General NPI Number Information
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NPI Number | 1669846689
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Entity Type | Individual
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Provider Name | BROCK MADSEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 1317 GROVE AVE
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City | MONTEVIDEO
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State | MN
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Zip | 56265-1708
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Country | US
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Telephone | 320-269-7135
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Fax | 320-269-7583
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Provider Business Mailing Address
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Address Line | 525 LEGION DR STE #1
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City | MONTEVIDEO
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State | MN
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Zip | 56265-1722
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Country | US
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Telephone | 320-269-7135
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Fax | 320-269-7583
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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 | 6138
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License Number State | MN
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