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General NPI Number Information
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NPI Number | 1902138423
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Entity Type | Individual
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Provider Name | RYAN STOFFLE D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2010
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 200 AKEHURST AVE
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City | SYLVAN BEACH
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State | NY
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Zip | 13157
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Country | US
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Telephone | 315-303-2225
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 184
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City | SYLVAN BEACH
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State | NY
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Zip | 13157-0184
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Country | US
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Telephone | 315-303-2225
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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 | XO11972
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License Number State | NY
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