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General NPI Number Information
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NPI Number | 1396057444
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Entity Type | Organization
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Legal Business Name | K. M. RACHOW ENTERPRISES LLC
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 2200 MORRISS RD SUITE 200
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City | FLOWER MOUND
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State | TX
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Zip | 75028-3598
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Country | US
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Telephone | 972-874-5900
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Fax | 972-874-5905
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Provider Business Mailing Address
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Address Line | 2200 MORRISS RD SUITE 200
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City | FLOWER MOUND
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State | TX
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Zip | 75028-3598
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Country | US
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Telephone | 972-874-5900
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Fax | 972-874-5905
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH EDWIN RACHOW
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Credential | DC
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Telephone | 972-539-3105
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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 | 11501
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License Number State | TX
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