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General NPI Number Information
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NPI Number | 1023432846
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Entity Type | Organization
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Legal Business Name | SAGE MEDICINE, LLC
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 258 A ST SUITE 20
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City | ASHLAND
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State | OR
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Zip | 97520-1947
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Country | US
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Telephone | 541-708-0642
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Fax |
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Provider Business Mailing Address
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Address Line | 1012 E MAIN ST
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City | ASHLAND
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State | OR
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Zip | 97520-2123
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Country | US
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Telephone | 541-708-0642
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Fax |
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Authorized Official
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Title or Position | CO-OWER
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Name | DAVID KAMINKER
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Credential | LAC, MSOM
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Telephone | 541-708-0642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC157420
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License Number State | OR
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