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General NPI Number Information
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NPI Number | 1780456897
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Entity Type | Organization
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Legal Business Name | ELEVATE CHIROPRACTIC AND PERFORMANCE THERAPY PLLC
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 114 WILKESBORO AVE
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-4218
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Country | US
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Telephone | 336-223-6058
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Fax |
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Provider Business Mailing Address
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Address Line | 863 NIKANOR RD
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City | WEST JEFFERSON
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State | NC
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Zip | 28694-7266
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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 | OWNER/OPERATOR
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Name | DR. DAVID MATTHEW CAMPBELL
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Credential | DC, CCSP, MS
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Telephone | 704-609-3029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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