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General NPI Number Information
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NPI Number | 1457591349
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Entity Type | Organization
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Legal Business Name | MIDDLETOWN CHIROPRACTIC CLINIC, INC.
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 03/26/2009
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Provider Practice Location Address
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Address Line | 23998 STATE LINE RD
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City | LAWRENCEBURG
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State | IN
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Zip | 47025-9653
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Country | US
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Telephone | 812-656-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 23998 STATE LINE RD
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City | LAWRENCEBURG
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State | IN
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Zip | 47025-9653
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Country | US
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Telephone | 812-656-8300
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TOMMY R THOMPSON
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Credential | D.C.
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Telephone | 513-727-9199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2072
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License Number State | OH
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