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General NPI Number Information
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NPI Number | 1972728467
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Entity Type | Organization
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Legal Business Name | ACTIVE CARE CHIROPRACTIC, INC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2821 N BALLAS RD SUITE C 55
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2321
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Country | US
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Telephone | 314-989-1805
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Fax | 314-989-1836
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Provider Business Mailing Address
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Address Line | 2821 N BALLAS RD SUITE C 55
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2321
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Country | US
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Telephone | 314-989-1805
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Fax | 314-989-1836
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PILAR MINETT WILLIAMSEN
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Credential | D.C.
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Telephone | 314-989-1805
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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 |
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License Number State |
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