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NPI 1063436053

NPI 1063436053 : ROBERT WAYNE KOVACS D.C. : GILROY, CA

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General NPI Number Information
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    NPI Number           |    1063436053
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT WAYNE KOVACS D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/26/2006
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    Last Update Date     |    03/08/2010
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Provider Practice Location Address
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    Address Line         |    7888 WREN AVE SUITE B123
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    City                 |    GILROY
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    State                |    CA
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    Zip                  |    95020-4962
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    Country              |    US
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    Telephone            |    408-848-3666
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    Fax                  |    408-848-3667
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Provider Business Mailing Address
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    Address Line         |    7888 WREN AVE SUITE B123
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    City                 |    GILROY
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    State                |    CA
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    Zip                  |    95020-4962
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    Country              |    US
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    Telephone            |    408-848-3666
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    Fax                  |    408-848-3667
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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       |    17234
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    License Number State |    CA
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