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General NPI Number Information
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NPI Number | 1083734446
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Entity Type | Organization
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Legal Business Name | MCLEOD EASTPOINTE CHIROPRACTIC, PC
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 21349 KELLY RD
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City | EASTPOINTE
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State | MI
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Zip | 48021-3217
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Country | US
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Telephone | 586-774-8492
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Fax |
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Provider Business Mailing Address
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Address Line | 21349 KELLY RD
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City | EASTPOINTE
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State | MI
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Zip | 48021-3217
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Country | US
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Telephone | 586-774-8492
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS ALLEN MCLEOD
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Credential | D.O.
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Telephone | 586-774-8492
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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 | 2301005579
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License Number State | MI
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