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General NPI Number Information
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NPI Number | 1013452028
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Entity Type | Individual
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Provider Name | ASHLEY MOODY DC
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Gender | Female
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 421 BROAD ST STE 4
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City | UTICA
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State | NY
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Zip | 13501-1210
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Country | US
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Telephone | 315-733-0590
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Fax | 315-693-1141
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Provider Business Mailing Address
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Address Line | 421 BROAD ST STE 4
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City | UTICA
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State | NY
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Zip | 13501-1210
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Country | US
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Telephone | 315-733-0590
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Fax | 315-693-1141
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DCP00651
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 013028
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License Number State | NY
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