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General NPI Number Information
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NPI Number | 1568829471
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Entity Type | Organization
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Legal Business Name | GORGE CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 01/22/2016
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Last Update Date | 11/12/2021
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Provider Practice Location Address
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Address Line | 1790 MAY ST STE B
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City | HOOD RIVER
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State | OR
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Zip | 97031-1369
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Country | US
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Telephone | 541-630-4442
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Fax | 844-444-1129
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Provider Business Mailing Address
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Address Line | 1790 MAY ST STE B
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City | HOOD RIVER
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State | OR
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Zip | 97031-1369
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Country | US
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Telephone | 541-630-4442
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Fax | 844-444-1129
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER MORROW
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Credential | DC
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Telephone | 541-630-4442
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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 | 5090
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License Number State | OR
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