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General NPI Number Information
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NPI Number | 1104143445
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Entity Type | Organization
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Legal Business Name | MISSOURI UPPER CERVICAL FAMILY CLINIC LLC
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 04/27/2010
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Provider Practice Location Address
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Address Line | 815 N FOUNTAIN ST
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-7201
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Country | US
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Telephone | 573-579-4735
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Fax |
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Provider Business Mailing Address
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Address Line | 815 N. FOUNTAIN ST
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701
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Country | US
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Telephone | 573-579-4735
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENDRICK MORRIS
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Credential | D.C
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Telephone | 573-275-0336
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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 |
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License Number State |
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