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General NPI Number Information
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NPI Number | 1255652533
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Entity Type | Organization
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Legal Business Name | DESERT SHADOWS CHIROPRACTIC & WELLNESS
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 4010 E BELL RD SUITE #103
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City | PHOENIX
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State | AZ
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Zip | 85032-2229
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Country | US
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Telephone | 602-595-0015
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Fax | 602-595-0091
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Provider Business Mailing Address
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Address Line | 4010 E BELL RD SUITE #103
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City | PHOENIX
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State | AZ
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Zip | 85032-2229
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Country | US
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Telephone | 602-595-0015
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Fax | 602-595-0091
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Authorized Official
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Title or Position | MEMBER
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Name | DR. CHRISTOPHER CARLTON CAMPO
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Credential | DC
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Telephone | 602-595-0015
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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 | 8087
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License Number State | AZ
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