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General NPI Number Information
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NPI Number | 1073796876
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC FAMILY HEALTH CENTER
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 2250 COMMERCIAL ST NE
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City | SALEM
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State | OR
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Zip | 97301-0716
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Country | US
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Telephone | 503-581-7590
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Fax | 503-581-6641
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Provider Business Mailing Address
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Address Line | 2250 COMMERCIAL ST NE
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City | SALEM
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State | OR
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Zip | 97301-0716
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Country | US
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Telephone | 503-581-7590
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Fax | 503-581-6641
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KRISTA G BOND
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Credential |
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Telephone | 503-581-7590
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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 | 1933
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License Number State | OR
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