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General NPI Number Information
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NPI Number | 1841881307
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Entity Type | Individual
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Provider Name | LUCAS EMMERICH DC
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Gender | Male
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 16301 KENRICK AVE
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City | LAKEVILLE
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State | MN
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Zip | 55044-8494
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Country | US
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Telephone | 952-595-6337
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Fax | 952-595-6336
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Provider Business Mailing Address
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Address Line | 1451 BLUESTEM BLVD STE C
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City | ALTOONA
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State | WI
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Zip | 54720-2619
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Country | US
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Telephone | 715-304-3683
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Fax | 715-304-3679
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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 | 6798
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6143-12
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License Number State | WI
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