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1669560280
MAXIM I IVANOV
GOSHEN, IN
NPI
1669560280
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
111N00000X Chiropractor
(Licence: IN 08002243A)
Enumeration Date
2006-10-10
Last Update Date
2007-07-08
Business Address
MAXIM I IVANOV D.C.
401 E MADISON ST
GOSHEN, IN 46526-3431
Phone number: 574-533-7363
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Mailing Address
MAXIM I IVANOV D.C.
401 E MADISON ST
GOSHEN, IN 46526-3431
Phone number: 574-533-7363
Copy
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