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General NPI Number Information
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NPI Number | 1710143540
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Entity Type | Organization
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Legal Business Name | FOSS CHIROPRACTIC PC
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 1021 DAKOTA AVE
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City | LIBBY
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State | MT
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Zip | 59923-2207
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Country | US
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Telephone | 406-293-8736
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Fax | 406-293-8737
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Provider Business Mailing Address
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Address Line | PO BOX 1528
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City | LIBBY
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State | MT
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Zip | 59923-1528
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Country | US
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Telephone | 406-293-8736
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Fax | 406-293-8737
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. SCOTT M FOSS
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Credential | DC
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Telephone | 406-293-8736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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