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General NPI Number Information
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NPI Number | 1861700569
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Entity Type | Individual
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Provider Name | MICHAEL JOSHUA STEPHENS D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 12/20/2016
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Provider Practice Location Address
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Address Line | 295 SOUTHWEST PLZ
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City | ARLINGTON
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State | TX
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Zip | 76016-4455
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Country | US
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Telephone | 863-202-0031
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Fax |
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Provider Business Mailing Address
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Address Line | 308 SW 15TH ST
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City | OKEECHOBEE
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State | FL
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Zip | 34974-5260
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Country | US
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Telephone | 863-202-0031
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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 | CH9803
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License Number State | FL
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