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General NPI Number Information
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NPI Number | 1144909375
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Entity Type | Individual
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Provider Name | JOEL K MACKES
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Gender | Male
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 16-590 OLD VOLCANO RD
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City | KEAAU
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State | HI
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Zip | 96749-8158
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Country | US
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Telephone | 408-809-1844
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Fax |
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Provider Business Mailing Address
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Address Line | 8131 WILDWOOD CIR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-6767
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Country | US
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Telephone | 949-394-3624
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 34859
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License Number State | CA
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