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1972971745
JACK SIMONSEN
BURNSVILLE, MN
NPI
1972971745
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MN 104750)
Enumeration Date
2015-09-09
Last Update Date
2015-09-09
Business Address
-- JACK SIMONSEN
2029 SOUTHCROSS DR W APT 308
BURNSVILLE, MN 55306-7929
Phone number: 952-239-0637
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Mailing Address
-- JACK SIMONSEN
2029 SOUTHCROSS DR W APT 308
BURNSVILLE, MN 55306-7929
Phone number:
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