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1356932073
JONATHAN BACKSTROM, LLC
DAVENPORT, IA
NPI
1356932073
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Entity Type
Organization
Authorized Contact
JON BACKSTROM
Therapist
563-650-5863
Organization Subpart ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2021-01-27
Last Update Date
2021-01-27
Business Address
JONATHAN BACKSTROM, LLC
2625 W 36TH ST
DAVENPORT, IA 52806-5224
Phone number: 563-650-5863
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Mailing Address
JONATHAN BACKSTROM, LLC
2625 W 36TH ST
DAVENPORT, IA 52806-5224
Phone number: 563-650-5863
Copy
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