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General NPI Number Information
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NPI Number | 1629252382
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Entity Type | Organization
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Legal Business Name | LOGICAL HEALTH SOLUTIONS
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 5415 SECOR RD
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City | TOLEDO
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State | OH
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Zip | 43623-1921
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Country | US
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Telephone | 419-472-8790
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Fax | 419-472-8792
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Provider Business Mailing Address
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Address Line | 5415 SECOR RD
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City | TOLEDO
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State | OH
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Zip | 43623-1921
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Country | US
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Telephone | 419-472-8790
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Fax | 419-472-8792
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | MR. BRIAN JAMES FILLMORE
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Credential | D.C.
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Telephone | 419-472-8790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 3009
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License Number State | OH
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