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General NPI Number Information
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NPI Number | 1386686863
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Entity Type | Organization
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Legal Business Name | REESE FAMILY CHIROPRACTIC SERVICE CORPORATION
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 265 N WESTGATE AVE REESE FAMILY CHIROPRACTIC SC
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City | JACKSONVILLE
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State | IL
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Zip | 62650
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Country | US
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Telephone | 217-245-4810
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Fax | 217-245-0931
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Provider Business Mailing Address
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Address Line | 265 N WESTGATE AVE REESE FAMILY CHIROPRACTIC SC
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City | JACKSONVILLE
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State | IL
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Zip | 62650
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Country | US
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Telephone | 217-245-4810
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Fax | 217-245-0931
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MR. DOUGLAS K REESE
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Credential | DC
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Telephone | 217-245-4810
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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 | IL
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