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NPI 1861936874

NPI 1861936874 : SIMONSON HEARING SERVICES, INC : COKATO, MN

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General NPI Number Information
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    NPI Number           |    1861936874
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    Entity Type          |    Organization 
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    Legal Business Name  |    SIMONSON HEARING SERVICES, INC 
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Dates
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    Enumeration Date     |    12/09/2016
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    Last Update Date     |    12/09/2016
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Provider Practice Location Address
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    Address Line         |    235 BROADWAY AVE S 
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    City                 |    COKATO
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    State                |    MN
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    Zip                  |    55321-1901
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    Country              |    US
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    Telephone            |    320-559-0333
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    760 NORRIS AVE SW 
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    City                 |    COKATO
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    State                |    MN
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    Zip                  |    55321-4137
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    Country              |    US
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    Telephone            |    320-559-0333
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. TRAVIS  SIMONSON 
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    Credential           |    H.I.S.
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    Telephone            |    320-559-0333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    237700000X
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    Taxonomy Name        |    Hearing Instrument Specialist
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    License Number       |    
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    License Number State |    
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