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General NPI Number Information
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NPI Number | 1356519367
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Entity Type | Organization
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Legal Business Name | MIDTOWN PAIN AND REHABILITATION CENTER
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 2117 CHENEVERT ST STE J
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City | HOUSTON
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State | TX
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Zip | 77003-5845
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Country | US
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Telephone | 713-650-6656
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Fax | 713-655-1118
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Provider Business Mailing Address
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Address Line | 2117 CHENEVERT ST STE J
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City | HOUSTON
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State | TX
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Zip | 77003-5845
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Country | US
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Telephone | 713-650-6656
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Fax | 713-655-1118
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTOR
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Name | LAURA T LE
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Credential |
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Telephone | 713-650-6656
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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 | DC8151
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License Number State | TX
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