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General NPI Number Information
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NPI Number | 1770781908
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Entity Type | Organization
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Legal Business Name | BALANCED APPROACH CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 500 SW 3RD ST SUITE D
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City | LEES SUMMIT
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State | MO
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Zip | 64063-2211
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Country | US
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Telephone | 816-246-2663
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Fax | 816-246-2614
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Provider Business Mailing Address
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Address Line | 500 SW 3RD ST SUITE D
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City | LEES SUMMIT
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State | MO
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Zip | 64063-2211
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Country | US
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Telephone | 816-246-2663
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Fax | 816-246-2614
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Authorized Official
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Title or Position | MANAGER
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Name | DR. MITCHELL S SIMON
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Credential | DC
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Telephone | 816-246-2663
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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 | 2004015447
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License Number State | MO
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