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General NPI Number Information
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NPI Number | 1881889061
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Entity Type | Organization
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Legal Business Name | RAINBOW THERAPEUTICS, INC.
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 224 N 5TH ST
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City | BRAINERD
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State | MN
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Zip | 56401-3348
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Country | US
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Telephone | 218-330-5305
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Fax | 218-825-3855
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Provider Business Mailing Address
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Address Line | 224 N 5TH ST
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City | BRAINERD
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State | MN
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Zip | 56401-3348
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Country | US
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Telephone | 218-330-5305
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Fax | 218-825-3855
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRIAN COHEE CALDERON
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Credential | BA, CMT, CST-D
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Telephone | 218-330-5305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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