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NPI 1457397887

NPI 1457397887 : THOMAS O POPOW D.C. : HOLLY SPRINGS, NC

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General NPI Number Information
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    NPI Number           |    1457397887
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    Entity Type          |    Individual 
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    Provider Name        |    THOMAS O POPOW D.C.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/22/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1100 HOLLY SPRINGS RD SUITE 100
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    City                 |    HOLLY SPRINGS
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    State                |    NC
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    Zip                  |    27540-9469
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    Country              |    US
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    Telephone            |    919-577-3974
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    Fax                  |    919-577-6351
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Provider Business Mailing Address
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    Address Line         |    216 CROSSFIRE RD 
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    City                 |    HOLLY SPRINGS
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    State                |    NC
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    Zip                  |    27540-8560
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    Country              |    US
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    Telephone            |    919-577-3974
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    Fax                  |    919-577-6351
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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       |    3019
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    License Number State |    NC
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