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General NPI Number Information
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NPI Number | 1104293117
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Entity Type | Organization
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Legal Business Name | KYLE MOSER DC LLC
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Dates
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Enumeration Date | 08/25/2015
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Last Update Date | 03/01/2020
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Provider Practice Location Address
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Address Line | 130 S HALCYON RD STE B
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3148
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Country | US
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Telephone | 805-481-8508
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Fax | 805-481-6839
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Provider Business Mailing Address
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Address Line | 130 S HALCYON RD STE B
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3148
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Country | US
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Telephone | 805-481-8508
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Fax | 805-481-6839
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. KYLE MOSER
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Credential | D.C.
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Telephone | 805-709-5343
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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 | 1259
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License Number State | HI
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