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General NPI Number Information
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NPI Number | 1205963048
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Entity Type | Individual
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Provider Name | MICHAEL CLOVER D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 03/04/2010
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Provider Practice Location Address
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Address Line | 455 SOUTH 4TH STREET
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City | LOUISVILLE
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State | KY
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Zip | 40203-1900
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Country | US
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Telephone | 502-587-7246
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Fax | 502-587-7266
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Provider Business Mailing Address
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Address Line | 455 S 4TH ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-2593
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Country | US
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Telephone | 502-587-7246
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Fax | 502-587-7266
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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 | 4850
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License Number State | KY
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