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General NPI Number Information
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NPI Number | 1518422468
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Entity Type | Organization
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Legal Business Name | STEWART CHIROPRACTIC & WELLNESS, LLC
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 1548 BLOOMINGDALE AVE
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City | VALRICO
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State | FL
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Zip | 33596-6101
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Country | US
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Telephone | 813-946-6283
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Fax | 813-322-2508
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Provider Business Mailing Address
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Address Line | 1548 BLOOMINGDALE AVE
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City | VALRICO
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State | FL
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Zip | 33596-6101
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Country | US
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Telephone | 813-946-6283
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. NICOLE A STEWART
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Credential | DC, CERTIFIED IN ACU
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Telephone | 813-946-6283
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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 |
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License Number State |
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