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General NPI Number Information
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NPI Number | 1861544900
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Entity Type | Individual
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Provider Name | JASON DAVIS FLEISNER DC
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5001 AMERICAN BLVD W #945
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City | BLOOMINGTON
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State | MN
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Zip | 55437-1162
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Country | US
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Telephone | 952-835-6653
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Fax | 952-835-3895
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Provider Business Mailing Address
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Address Line | 730 WEST VILLAGE ROAD #106
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City | CHANHASSEN
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State | MN
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Zip | 55317-7532
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Country | US
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Telephone | 612-384-7480
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Fax | 952-835-6653
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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 | 4718
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License Number State | MN
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