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General NPI Number Information
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NPI Number | 1902975253
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Entity Type | Individual
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Provider Name | CAROL ANN SAMUELS M.S.,D.C.
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6085 LAKE FORREST DR NW STE 300A
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City | ATLANTA
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State | GA
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Zip | 30328-3892
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Country | US
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Telephone | 404-843-3040
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Fax | 404-843-0119
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Provider Business Mailing Address
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Address Line | 6085 LAKE FORREST DR NW STE 300A
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City | ATLANTA
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State | GA
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Zip | 30328-3892
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Country | US
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Telephone | 404-843-3040
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Fax | 404-843-0119
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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 | 2331
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4812
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License Number State | FL
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