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1033456306
ERIC STAVENGER
GOLDEN VALLEY, MN
NPI
1033456306
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: MN 9077)
Enumeration Date
2013-01-07
Last Update Date
2013-01-07
Business Address
ERIC STAVENGER DPT
7505 COUNTRY CLUB DR
GOLDEN VALLEY, MN 55427-4501
Phone number: 763-450-6902
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Mailing Address
ERIC STAVENGER DPT
7505 COUNTRY CLUB DR
GOLDEN VALLEY, MN 55427-4501
Phone number:
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