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Individual

MR. LOREN DALE KMETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AUDIOLOGIST

Contact information

Practice address
215 N 3RD ST, BRAINERD, MN 56401-3331
(218) 829-2162
(218) 828-5013
Mailing address
215 N 3RD ST, BRAINERD, MN 56401-3331
(218) 829-2162
(218) 828-5013

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
7307
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
161081
UCARE
MN
05
266652900
MN
01
96G70KM
BLUE CROSS BLUE SHIELD
MN
Enumeration date
10/26/2008
Last updated
10/26/2008
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