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NPI 1780707729

NPI 1780707729 : VINCENT JEROME CASEY CHIROPRACTOR : RENO, NV

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General NPI Number Information
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    NPI Number           |    1780707729
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    Entity Type          |    Individual 
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    Provider Name        |    VINCENT JEROME CASEY CHIROPRACTOR
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/06/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    5150 MAE ANNE AVE STE 405 
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89523-1859
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    Country              |    US
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    Telephone            |    775-747-0600
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5266 SIMONS DR 
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89523-1871
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    Country              |    US
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    Telephone            |    775-747-7819
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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       |    B-336
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    License Number State |    NV
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