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General NPI Number Information
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NPI Number | 1972792307
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Entity Type | Organization
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Legal Business Name | SPRING CHIROPRACTIC & REHAB PC
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 19510 KUYKENDAHL RD STE A
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City | SPRING
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State | TX
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Zip | 77379-3408
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Country | US
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Telephone | 281-651-7111
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Fax | 281-288-9550
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Provider Business Mailing Address
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Address Line | 19510 KUYKENDAHL RD STE A
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City | SPRING
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State | TX
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Zip | 77379-3408
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Country | US
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Telephone | 281-651-7111
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Fax | 281-288-9550
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Authorized Official
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Title or Position | OWNER
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Name | MR. SCOTT THOMAS BOLZ
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Credential | DC
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Telephone | 281-651-7111
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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 | 6962
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License Number State | TX
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