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General NPI Number Information
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NPI Number | 1467678284
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Entity Type | Organization
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Legal Business Name | ACCIDENT CARE CHIROPRACTIC & HOLISTIC MEDICINE, INC.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 05/13/2009
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Provider Practice Location Address
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Address Line | 1205 MONUMENT RD SUITE 301
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City | JACKSONVILLE
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State | FL
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Zip | 32225-7406
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Country | US
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Telephone | 904-725-6007
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Fax | 904-725-6009
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Provider Business Mailing Address
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Address Line | 1205 MONUMENT RD SUITE 301
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City | JACKSONVILLE
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State | FL
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Zip | 32225-7406
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Country | US
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Telephone | 904-725-6007
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Fax | 904-725-6009
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | JOYCE TUCKER
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Credential |
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Telephone | 904-272-3440
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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 | CH5444
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License Number State | FL
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