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General NPI Number Information
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NPI Number | 1487725487
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Entity Type | Individual
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Provider Name | PATRICK DALE MOORE D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 8258 ROCKVILLE ROAD
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City | INDIANAPOLIS
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State | IN
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Zip | 46214-0000
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Country | US
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Telephone | 317-429-5400
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Fax | 317-429-5401
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Provider Business Mailing Address
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Address Line | 502 E MARKET ST
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-1817
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Country | US
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Telephone | 765-362-1500
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Fax | 765-361-8919
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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 | 08001595
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License Number State | IN
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