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NPI 1730866427

NPI 1730866427 : GARRET GAY : SPARTANBURG, SC

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General NPI Number Information
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    NPI Number           |    1730866427
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    Entity Type          |    Individual 
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    Provider Name        |    GARRET GAY
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/03/2023
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    Last Update Date     |    07/03/2023
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Provider Practice Location Address
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    Address Line         |    1855 E MAIN ST STE 18 
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    City                 |    SPARTANBURG
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    State                |    SC
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    Zip                  |    29307-2326
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    Country              |    US
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    Telephone            |    864-532-5165
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    160 ANDERSON DR 
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    City                 |    SPARTANBURG
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    State                |    SC
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    Zip                  |    29302-3063
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    Country              |    US
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    Telephone            |    
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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       |    4978
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    License Number State |    SC
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