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Individual

DR. TIMOTHY JON VAAGENES SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
200 VILLAGE CENTER DR, SUITE 100, NORTH OAKS, MN 55127-7090
(651) 415-0446
Mailing address
2508 HIGHWAY 70, BRAHAM, MN 55006-3759
(320) 396-5068

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3144
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3C231VA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
01/22/2007
Last updated
07/08/2007
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