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General NPI Number Information
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NPI Number | 1003150327
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Entity Type | Organization
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Legal Business Name | MRS MOBILE RADIOLOGIC SERVICE LTD
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Dates
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Enumeration Date | 11/27/2012
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Last Update Date | 03/25/2013
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Provider Practice Location Address
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Address Line | 419 E FRONT ST
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City | DOVER
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State | OH
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Zip | 44622-1869
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Country | US
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Telephone | 330-343-1846
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Fax |
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Provider Business Mailing Address
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Address Line | 419 E FRONT ST
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City | DOVER
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State | OH
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Zip | 44622-1869
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | LYNDA SHALOSKY
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Credential |
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Telephone | 330-447-9159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number | 79220
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | R2537365
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 79220
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License Number State | OH
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