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General NPI Number Information
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NPI Number | 1487912341
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Entity Type | Organization
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Legal Business Name | WATSON CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/30/2012
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 10663 SW 14TH PL
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City | DAVIE
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State | FL
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Zip | 33324-7128
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Country | US
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Telephone | 954-483-5938
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Fax | 954-252-4117
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Provider Business Mailing Address
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Address Line | 10663 SW 14TH PL
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City | DAVIE
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State | FL
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Zip | 33324-7128
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Country | US
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Telephone | 954-483-5938
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Fax | 954-252-4117
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Authorized Official
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Title or Position | SOLE MBR
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Name | DR. ASHLEY MARIE WATSON-DOSTER
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Credential | D.C.
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Telephone | 954-483-5938
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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 | CH 10528
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License Number State | FL
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