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General NPI Number Information
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NPI Number | 1750335659
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Entity Type | Organization
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Legal Business Name | CLINE CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 11/24/2010
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Provider Practice Location Address
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Address Line | 1033 SAGAMORE PARK WAY WEST
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906
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Country | US
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Telephone | 765-463-3000
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Fax | 765-463-3000
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Provider Business Mailing Address
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Address Line | 1033 SAGAMORE PARK WAY WEST
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906
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Country | US
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Telephone | 765-463-3000
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Fax | 765-463-3000
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ADAM BEEN CLINE
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Credential | DC
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Telephone | 765-463-3000
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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 | 08002157A
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License Number State | IN
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