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General NPI Number Information
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NPI Number | 1235393604
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Entity Type | Organization
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Legal Business Name | ANGEL CHIROPRACTIC CENTER, LLC
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 641 ROBBINS AVE
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City | NILES
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State | OH
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Zip | 44446-2413
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Country | US
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Telephone | 330-652-6435
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Fax | 330-652-1662
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Provider Business Mailing Address
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Address Line | 5667 MAHONING AVE
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City | AUSTINTOWN
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State | OH
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Zip | 44515-2301
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Country | US
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Telephone | 330-270-2350
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Fax | 330-270-2351
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MRS. KATHY HURDLEY
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Credential |
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Telephone | 330-270-2350
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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 | 3420
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License Number State | OH
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