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NPI 1366537169

NPI 1366537169 : KEVIN W. DAVIS D.C. : NORFOLK, NE

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General NPI Number Information
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    NPI Number           |    1366537169
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    Entity Type          |    Individual 
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    Provider Name        |    KEVIN W. DAVIS D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/04/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1502 N 13TH ST 
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    City                 |    NORFOLK
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    State                |    NE
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    Zip                  |    68701-2381
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    Country              |    US
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    Telephone            |    402-371-6415
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    Fax                  |    402-371-2883
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1371 
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    City                 |    NORFOLK
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    State                |    NE
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    Zip                  |    68702-1371
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    Country              |    US
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    Telephone            |    402-371-6415
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    Fax                  |    402-371-2883
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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       |    677
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    License Number State |    NE
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