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General NPI Number Information
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NPI Number | 1427079433
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Entity Type | Organization
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Legal Business Name | BACK IN MOTION CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 10/20/2009
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Provider Practice Location Address
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Address Line | 201 E WASHINGTON AVE
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City | LOVINGTON
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State | NM
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Zip | 88260-4020
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Country | US
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Telephone | 575-739-2225
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Fax | 575-739-2225
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Provider Business Mailing Address
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Address Line | PO BOX 1514
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City | LOVINGTON
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State | NM
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Zip | 88260-1514
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Country | US
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Telephone | 575-739-2225
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Fax | 575-739-2225
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | KATHLEEN TAYLOR
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Credential |
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Telephone | 575-396-5431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 1658
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License Number State | NM
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