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General NPI Number Information
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NPI Number | 1154587483
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Entity Type | Organization
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Legal Business Name | WARDS CORNER CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 08/06/2008
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 550 WARDS CORNER RD. SUITE 101
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City | LOVELAND
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State | OH
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Zip | 45140-6149
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Country | US
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Telephone | 513-677-6787
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Fax | 513-677-2260
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Provider Business Mailing Address
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Address Line | 550 WARDS CORNER RD. SUITE 101
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City | LOVELAND
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State | OH
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Zip | 45140-6149
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Country | US
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Telephone | 513-677-6787
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Fax | 513-677-2260
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS R PORTMANN
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Credential |
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Telephone | 513-677-6787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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