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NPI 1023557022

NPI 1023557022 : RICHARD STORROW : ASHLAND, OH

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General NPI Number Information
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    NPI Number           |    1023557022
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    Entity Type          |    Individual 
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    Provider Name        |    RICHARD STORROW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/23/2017
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    Last Update Date     |    02/23/2017
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Provider Practice Location Address
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    Address Line         |    622 CENTER ST 
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    City                 |    ASHLAND
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    State                |    OH
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    Zip                  |    44805-3343
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    Country              |    US
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    Telephone            |    419-289-3523
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    622 CENTER ST 
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    City                 |    ASHLAND
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    State                |    OH
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    Zip                  |    44805-3343
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    Country              |    US
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    Telephone            |    419-289-3523
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    Fax                  |    
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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        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    6312
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    License Number State |    OH
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