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General NPI Number Information
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NPI Number | 1013141399
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Entity Type | Organization
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Legal Business Name | OPTICAL EXPRESSIONS PLLC
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 01/12/2016
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Provider Practice Location Address
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Address Line | 112 W MCDOWELL RD
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City | PHOENIX
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State | AZ
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Zip | 85003
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Country | US
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Telephone | 602-254-3169
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Fax | 602-256-7112
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Provider Business Mailing Address
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Address Line | 112 W MCDOWELL RD
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City | PHOENIX
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State | AZ
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Zip | 85003
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Country | US
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Telephone | 602-254-3169
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Fax | 602-256-7112
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Authorized Official
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Title or Position | OWNER/MEMBER/PARTNER
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Name | LAURIE SHAPIRO
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Credential |
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Telephone | 602-254-3169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 96003772
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1480
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License Number State | AZ
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