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General NPI Number Information
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NPI Number | 1992905145
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Entity Type | Organization
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Legal Business Name | MYHERS CHIROPRACTIC INC
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 13818 7TH ST
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City | OSSEO
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State | WI
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Zip | 54758-7402
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Country | US
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Telephone | 715-597-3388
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Fax | 715-597-2688
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Provider Business Mailing Address
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Address Line | PO BOX 336
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City | OSSEO
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State | WI
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Zip | 54758-0336
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Country | US
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Telephone | 715-597-3388
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Fax | 715-597-2688
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BONITA R MYHERS
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Credential | DC
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Telephone | 715-597-3388
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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 | 3101-012
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License Number State | WI
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