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General NPI Number Information
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NPI Number | 1710318076
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Entity Type | Organization
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Legal Business Name | MOBILE CHIROPRACTIC
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 13865 S DIXIE HWY SUITE 307
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City | MIAMI
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State | FL
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Zip | 33176-7221
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Country | US
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Telephone | 305-252-9090
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Fax | 305-252-9058
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Provider Business Mailing Address
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Address Line | 13865 S DIXIE HWY SUITE 307
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City | MIAMI
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State | FL
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Zip | 33176-7221
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Country | US
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Telephone | 305-252-9090
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Fax | 305-252-9058
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. SUSAN CRUZ
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Credential |
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Telephone | 305-252-9090
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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 | CH4396
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License Number State | FL
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