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General NPI Number Information
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NPI Number | 1720333834
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Entity Type | Organization
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Legal Business Name | LOHAN CHIROPRACTIC AND ACUPUNCTURE CLINIC LLC
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 07/16/2012
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Provider Practice Location Address
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Address Line | 404 E BANNISTER RD STE B
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City | KANSAS CITY
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State | MO
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Zip | 64131-3020
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Country | US
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Telephone | 816-444-1218
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Fax | 866-291-2490
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Provider Business Mailing Address
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Address Line | 404 E BANNISTER RD STE B
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City | KANSAS CITY
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State | MO
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Zip | 64131-3020
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Country | US
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Telephone | 816-444-1218
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Fax | 866-291-2490
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Authorized Official
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Title or Position | OWNER
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Name | MI SUN KIM
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Credential |
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Telephone | 816-444-1218
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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 | 01-05485
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2012016839
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License Number State | MO
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