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General NPI Number Information
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NPI Number | 1700908977
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Entity Type | Individual
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Provider Name | MICHAEL WAYNE RENGERT D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4434 CARVER WOODS DR
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City | BLUE ASH
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State | OH
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Zip | 45242-5531
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Country | US
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Telephone | 513-489-9515
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Fax | 513-489-8350
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Provider Business Mailing Address
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Address Line | 5118 S COUNTY ROAD 300 E
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City | LIBERTY
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State | IN
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Zip | 47353-9334
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Country | US
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Telephone | 765-732-3090
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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 | 1161
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License Number State | OH
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