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General NPI Number Information
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NPI Number | 1386869121
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Entity Type | Organization
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Legal Business Name | JOSEPH M LOGRASSO DC PC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 22701 GREATER MACK AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2007
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Country | US
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Telephone | 586-777-6056
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Fax | 586-775-7246
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Provider Business Mailing Address
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Address Line | 22701 GREATER MACK AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2007
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Country | US
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Telephone | 586-777-6056
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Fax | 586-775-7246
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Authorized Official
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Title or Position | DOCTOR
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Name | JOSEPH M LOGRASSO
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Credential | DC
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Telephone | 586-777-6056
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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 | JL002224
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License Number State | MI
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