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General NPI Number Information
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NPI Number | 1609038603
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Entity Type | Organization
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Legal Business Name | FIELDER CHIROPRACTIC
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 2817 OCEAN PARK BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90405
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Country | US
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Telephone | 310-450-5848
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Fax |
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Provider Business Mailing Address
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Address Line | 2817 OCEAN PARK BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90405
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Country | US
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Telephone | 310-450-5848
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ARTHUR FIELDER
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Credential |
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Telephone | 310-450-5848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC16115
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License Number State | CA
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