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General NPI Number Information
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NPI Number | 1043713498
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Entity Type | Individual
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Provider Name | JAMES WILLIAM LOVELL
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Gender | Male
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 1500 S AVENUE K
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City | PORTALES
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State | NM
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Zip | 88130-7400
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Country | US
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Telephone | 575-562-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 14407 98TH WAY SE
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City | YELM
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State | WA
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Zip | 98597-7724
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Country | US
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Telephone | 360-972-9365
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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