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General NPI Number Information
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NPI Number | 1386197663
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Entity Type | Organization
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Legal Business Name | FOWLER CHIROPRACTIC
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 08/03/2016
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Provider Practice Location Address
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Address Line | 1035 HARVEY ROAD
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City | AUBURN
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State | WA
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Zip | 98002
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Country | US
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Telephone | 253-833-0522
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Fax |
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Provider Business Mailing Address
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Address Line | 1035 HARVEY RD NE
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City | AUBURN
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State | WA
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Zip | 98002-4221
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Country | US
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Telephone | 253-833-0522
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ROXANNA G FOWLER
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Credential | D.C.
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Telephone | 253-833-0522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MA00017301
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License Number State | WA
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