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NPI 1417114596

NPI 1417114596 : WILLIAM MICHAEL MCCLUNE D.C. : SARATOGA SPRINGS, NY

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General NPI Number Information
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    NPI Number           |    1417114596
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM MICHAEL MCCLUNE D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/17/2008
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    Last Update Date     |    05/17/2008
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Provider Practice Location Address
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    Address Line         |    3303 ROUTE 9 
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    City                 |    SARATOGA SPRINGS
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    State                |    NY
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    Zip                  |    12866-6205
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    Country              |    US
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    Telephone            |    617-273-0118
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    Fax                  |    617-273-5609
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Provider Business Mailing Address
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    Address Line         |    10 LAKEVIEW RD 
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    City                 |    SARATOGA SPRINGS
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    State                |    NY
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    Zip                  |    12866-8705
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    Country              |    US
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    Telephone            |    617-273-0118
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    Fax                  |    617-273-5609
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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       |    1887
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    License Number State |    NY
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