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General NPI Number Information
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NPI Number | 1689602039
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Entity Type | Individual
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Provider Name | EDWIN D PORTER DM, DC
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4531 EVERHARD RD NW
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City | CANTON
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State | OH
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Zip | 44718-2406
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Country | US
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Telephone | 330-499-0642
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Fax | 330-499-2257
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Provider Business Mailing Address
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Address Line | 1247 MAXFLI DR
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City | AKRON
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State | OH
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Zip | 44312-5930
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Country | US
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Telephone | 330-936-4111
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Fax | 330-499-2257
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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 | 316
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License Number State | OH
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