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General NPI Number Information
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NPI Number | 1982297859
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Entity Type | Organization
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Legal Business Name | EXPERIENCE CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 02/11/2021
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Last Update Date | 02/11/2021
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Provider Practice Location Address
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Address Line | 7900 FM 1826 STE 100
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City | AUSTIN
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State | TX
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Zip | 78737-1410
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Country | US
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Telephone | 512-284-8834
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 E CREEK DR
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-4216
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Country | US
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Telephone | 512-484-4685
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ZACH J FOREMAN
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Credential | DC
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Telephone | 512-484-4685
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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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