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General NPI Number Information
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NPI Number | 1962052860
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Entity Type | Organization
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Legal Business Name | WESTWARD CHIROPRACTIC
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 1023 SANTA FE DR.
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City | DENVER
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State | CO
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Zip | 80204
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Country | US
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Telephone | 303-862-7708
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 E 16TH AVE APT 517
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City | DENVER
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State | CO
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Zip | 80206-1688
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Country | US
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Telephone | 787-607-6194
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LYANN AGRESAR
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Credential | DC
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Telephone | 787-607-6194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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