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1831880152
KRISJAN MIKKEL HENDERSON
AMES, IA
NPI
1831880152
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2023-05-17
Last Update Date
2023-05-17
Business Address
KRISJAN MIKKEL HENDERSON
534 WALLACE RD
AMES, IA 50011-4008
Phone number: 515-294-8718
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Mailing Address
KRISJAN MIKKEL HENDERSON
1501 W KENTUCKY AVE
INDIANOLA, IA 50125-4762
Phone number: 515-829-6540
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