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General NPI Number Information
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NPI Number | 1831464759
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Entity Type | Organization
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Legal Business Name | ROOT'S CHIROPRACTIC
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Dates
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Enumeration Date | 03/09/2012
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 1403 CENTRAL AVE
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City | HOT SPRINGS
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State | AR
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Zip | 71901-6149
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Country | US
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Telephone | 501-625-3446
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Fax | 501-762-0310
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Provider Business Mailing Address
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Address Line | 1419 CENTRAL AVE
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City | HOT SPRINGS
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State | AR
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Zip | 71901-6149
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Country | US
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Telephone | 501-625-2446
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Fax | 501-625-3448
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. JUSTIN KYLER POMEROY
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Credential | D.C.
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Telephone | 501-625-3446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 15939
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License Number State | AR
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