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General NPI Number Information
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NPI Number | 1598978330
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Entity Type | Organization
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Legal Business Name | GENESIS CHIROPRACTIC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2922 OAK LAWN AVE
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City | DALLAS
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State | TX
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Zip | 75219-4131
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Country | US
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Telephone | 214-219-4325
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Fax | 214-526-2267
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Provider Business Mailing Address
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Address Line | 2922 OAK LAWN AVE
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City | DALLAS
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State | TX
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Zip | 75219-4131
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Country | US
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Telephone | 214-219-4325
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Fax | 214-526-2267
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Authorized Official
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Title or Position | OWNER CLINIC DIRECTOR
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Name | DR. SAMUEL TURNER LAFFEL
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Credential | DC
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Telephone | 214-219-4325
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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 | 6705
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License Number State | TX
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