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NPI 1033515986

NPI 1033515986 : SCOTT BARTELL : WEST BEND, WI

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General NPI Number Information
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    NPI Number           |    1033515986
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    Entity Type          |    Individual 
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    Provider Name        |    SCOTT BARTELL
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/04/2014
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    Last Update Date     |    11/04/2014
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Provider Practice Location Address
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    Address Line         |    1201 OAK ST SUITE H
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    City                 |    WEST BEND
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    State                |    WI
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    Zip                  |    53095-3800
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    Country              |    US
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    Telephone            |    262-622-3602
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    W200N16833 PARK CT 
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    City                 |    JACKSON
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    State                |    WI
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    Zip                  |    53037-9420
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    Country              |    US
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    Telephone            |    262-622-3602
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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        |    171100000X
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    Taxonomy Name        |    Acupuncturist
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    License Number       |    829
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    License Number State |    WI
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