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General NPI Number Information
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NPI Number | 1548780067
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Entity Type | Organization
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Legal Business Name | FOSTER CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/26/2017
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Last Update Date | 07/05/2017
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Provider Practice Location Address
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Address Line | 5066 W ATLANTIC AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8129
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Country | US
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Telephone | 561-498-8005
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Fax | 561-498-8005
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Provider Business Mailing Address
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Address Line | 18770 STEWART CIR APT 7
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City | BOCA RATON
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State | FL
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Zip | 33496-6635
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Country | US
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Telephone | 561-549-1403
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Fax | 561-431-4642
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MR. IRA ROTHMAN
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Credential |
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Telephone | 561-549-1403
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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 | 10991
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License Number State | FL
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