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NPI 1255767323

NPI 1255767323 : JESSICA GUNDELFINGER D.C. : CLAYTON, NC

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General NPI Number Information
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    NPI Number           |    1255767323
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    Entity Type          |    Individual 
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    Provider Name        |    JESSICA GUNDELFINGER D.C.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/20/2013
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    Last Update Date     |    08/21/2014
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Provider Practice Location Address
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    Address Line         |    34 OLEANDER DR STE 104 
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    City                 |    CLAYTON
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    State                |    NC
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    Zip                  |    27527-4599
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    Country              |    US
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    Telephone            |    919-585-1313
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    Fax                  |    919-585-1350
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Provider Business Mailing Address
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    Address Line         |    34 OLEANDER DR STE 104 
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    City                 |    CLAYTON
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    State                |    NC
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    Zip                  |    27527-4599
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    Country              |    US
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    Telephone            |    919-585-1313
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    Fax                  |    919-585-1350
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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       |    558
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    License Number State |    AK
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Taxonomy #2
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    4506
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    License Number State |    NC
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