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General NPI Number Information
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NPI Number | 1073663696
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Entity Type | Individual
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Provider Name | MARY LECHNER O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 10/23/2009
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Provider Practice Location Address
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Address Line | 6880 PALM AVE
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City | SEBASTOPOL
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State | CA
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Zip | 95472-4270
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Country | US
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Telephone | 707-994-8644
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Fax |
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Provider Business Mailing Address
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Address Line | 2703 GALLOP DR
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City | SANTA ROSA
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State | CA
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Zip | 95407-4541
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Country | US
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Telephone | 707-280-8250
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Fax | 707-573-1759
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9681
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License Number State | CA
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