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General NPI Number Information
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NPI Number | 1235929183
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Entity Type | Organization
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Legal Business Name | KSMLLC
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | CENTRO NOVIOS PLAZA AVE. HOSTOS SUITE 204
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City | MAYAGUEZ
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State | PR
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Zip | 00680
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Country | US
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Telephone | 787-450-9601
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 140182
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City | ARECIBO
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State | PR
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Zip | 00614-0182
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Country | US
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Telephone | 787-450-9601
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | KENNETH LOUIS DE JESUS TORRES
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Credential | DC
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Telephone | 787-450-9601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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