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General NPI Number Information
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NPI Number | 1316793912
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Entity Type | Organization
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Legal Business Name | LS PAIN RELIEF CENTER PA
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 515 W LAKE ST STE F
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City | MINNEAPOLIS
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State | MN
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Zip | 55408-2981
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Country | US
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Telephone | 612-827-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 W ALAMEDA AVE STE 300
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City | BURBANK
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State | CA
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Zip | 91506-2705
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Country | US
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Telephone | 818-939-1351
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID NOAM KAY
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Credential | DO
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Telephone | 818-939-1351
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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 |
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License Number State |
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