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General NPI Number Information
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NPI Number | 1992070759
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Entity Type | Individual
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Provider Name | ALICIA MICHELLE STEPHENSON D.C.
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Gender | Female
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Dates
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Enumeration Date | 03/13/2012
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 1313 BRIARCREST DR
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City | BRYAN
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State | TX
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Zip | 77802-5241
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Country | US
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Telephone | 979-776-2828
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Fax | 979-776-2829
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Provider Business Mailing Address
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Address Line | 1313 BRIARCREST DR
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City | BRYAN
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State | TX
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Zip | 77802-5241
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Country | US
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Telephone | 979-776-2828
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Fax | 979-776-2829
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 11986
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License Number State | TX
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