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General NPI Number Information
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NPI Number | 1629441787
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Entity Type | Individual
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Provider Name | ALLISON MARIE STAFFORD D.C.
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Gender | Female
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 1807 ROUTE 209
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City | BRODHEADSVILLE
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State | PA
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Zip | 18322-7105
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Country | US
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Telephone | 507-992-2929
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 862
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City | SAYLORSBURG
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State | PA
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Zip | 18353-0862
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Country | US
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Telephone | 920-246-3495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC011092
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License Number State | PA
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