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General NPI Number Information
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NPI Number | 1356649396
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Entity Type | Organization
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Legal Business Name | DAVIS HOLISTIC HEALTH CENTER, INC.
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 02/28/2011
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Provider Practice Location Address
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Address Line | 1403 5TH ST STE B
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City | DAVIS
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State | CA
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Zip | 95616-3900
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Country | US
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Telephone | 530-758-7525
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Fax | 530-758-2129
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Provider Business Mailing Address
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Address Line | 1403 5TH ST STE B
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City | DAVIS
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State | CA
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Zip | 95616-3900
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Country | US
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Telephone | 530-758-7525
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Fax | 530-758-2129
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN DEMPSEY
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Credential | L.AC.
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Telephone | 530-758-7525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | AC4741
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License Number State | CA
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