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General NPI Number Information
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NPI Number | 1447540588
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Entity Type | Organization
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Legal Business Name | NOVICK CHIROPRACTIC P A
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 4801 S UNIVERSITY DR SUITE 107
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City | DAVIE
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State | FL
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Zip | 33328-3839
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Country | US
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Telephone | 954-434-2225
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Fax | 954-434-2228
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Provider Business Mailing Address
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Address Line | 4801 SOUTH UNIVERSITY DRIVE SUITE 107
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City | DAVIE
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State | FL
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Zip | 33328
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Country | US
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Telephone | 954-434-2225
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Fax | 954-434-2228
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. LAURENCE R NOVICK
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Credential | DC
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Telephone | 954-434-2225
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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 | CH4997
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License Number State | FL
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