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General NPI Number Information
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NPI Number | 1912778416
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Entity Type | Organization
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Legal Business Name | NEW JOURNEY CHIROPRACTOR AND WELLNESS LLC
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 1201 NE 26TH ST STE 106
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City | WILTON MANORS
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State | FL
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Zip | 33305-1206
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Country | US
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Telephone | 754-799-3852
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Fax | 754-799-3739
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Provider Business Mailing Address
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Address Line | 5372 NE 3RD AVE
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City | OAKLAND PARK
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State | FL
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Zip | 33334-1673
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Country | US
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Telephone | 786-503-9016
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. THOMAS MITCHELL WIEST
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Credential | DC, DIBCN
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Telephone | 754-799-3852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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