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General NPI Number Information
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NPI Number | 1992857080
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Entity Type | Organization
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Legal Business Name | GRAHAM CHIROPRACTIC ENTERPRISES
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6900 HOUSTON RD SUITE 17
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City | FLORENCE
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State | KY
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Zip | 41042
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Country | US
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Telephone | 859-283-1777
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Fax | 859-283-1703
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Provider Business Mailing Address
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Address Line | 6900 HOUSTON RD SUITE 17
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City | FLORENCE
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State | KY
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Zip | 41042
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Country | US
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Telephone | 859-283-1777
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Fax | 859-283-1703
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS W GRAHAM
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Credential | D.C.
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Telephone | 859-283-1777
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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 | 4583
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License Number State | KY
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