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General NPI Number Information
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NPI Number | 1215278395
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Entity Type | Organization
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Legal Business Name | CONCIERGE CHIROPRACTIC HEALTHCARE
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Dates
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Enumeration Date | 03/14/2013
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | 14843 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11435-3330
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Country | US
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Telephone | 718-880-2409
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Fax | 718-880-2413
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Provider Business Mailing Address
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Address Line | 2660 BELMILL RD
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City | BELLMORE
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State | NY
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Zip | 11710-4513
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Country | US
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Telephone | 516-984-7296
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. MARTIN MILLER
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Credential | D.C.
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Telephone | 516-984-7296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | X0058791
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License Number State | NY
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