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General NPI Number Information
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NPI Number | 1548160278
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Entity Type | Individual
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Provider Name | KAITLYN JUNE JACKSON DC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 903 MAIN ST
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City | ALAMOSA
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State | CO
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Zip | 81101-2443
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Country | US
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Telephone | 970-379-6598
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Fax |
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Provider Business Mailing Address
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Address Line | 35 S MEADOW CIR
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City | RIFLE
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State | CO
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Zip | 81650-3802
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Country | US
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Telephone | 970-379-6598
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Fax |
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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 | CHR.0009133
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License Number State | CO
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