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General NPI Number Information
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NPI Number | 1548464456
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Entity Type | Individual
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Provider Name | PRISCILLA JAMIESON D.C.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 115 3RD ST
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City | GREENPORT
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State | NY
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Zip | 11944-1642
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Country | US
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Telephone | 631-561-9906
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 421
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City | ORIENT
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State | NY
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Zip | 11957-0421
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Country | US
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Telephone | 631-561-9906
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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 | 70 010439
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License Number State | NY
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