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Individual

JAMES PAUL KOFOED

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
223 E BROADWAY, LITTLE FALLS, MN 56345-3137
(320) 632-6283
Mailing address
223 E BROADWAY, LITTLE FALLS, MN 56345-3137
(320) 632-6283

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1751
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
230427
CCMI
MN
05
4431886
MN
01
83114KO
BCBS PROVIDER
MN
01
89675KO
BCBS
MN
Enumeration date
12/06/2006
Last updated
07/09/2007
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