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General NPI Number Information
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NPI Number | 1104474014
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Entity Type | Organization
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Legal Business Name | MOHR CHIROPRACTIC CLINIC LLC
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 09/04/2019
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Provider Practice Location Address
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Address Line | 4031 S CRESTVIEW DR
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City | GREENCASTLE
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State | IN
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Zip | 46135-8704
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Country | US
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Telephone | 765-653-4447
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Fax |
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Provider Business Mailing Address
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Address Line | 4031 S CRESTVIEW DR
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City | GREENCASTLE
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State | IN
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Zip | 46135-8704
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Country | US
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Telephone | 765-653-4447
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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. JUSTIN D MOHR
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Credential | DC
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Telephone | 317-292-7944
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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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