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General NPI Number Information
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NPI Number | 1659404390
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Entity Type | Individual
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Provider Name | MICHAEL VINCENT GIACOPPO D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2613 W NORTHERN AVE
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City | PHOENIX
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State | AZ
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Zip | 85051-4850
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Country | US
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Telephone | 602-995-9597
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Fax | 602-995-9590
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Provider Business Mailing Address
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Address Line | 2613 W NORTHERN AVE
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City | PHOENIX
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State | AZ
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Zip | 85051-4850
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Country | US
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Telephone | 602-995-9597
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Fax | 602-995-9590
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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 | 3920
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License Number State | AZ
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