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General NPI Number Information
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NPI Number | 1073716189
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Entity Type | Organization
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Legal Business Name | MINDEN ORTHOPAEDICS & REHAB SERVICES, LLC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 216 W UNION ST SUITE A
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City | MINDEN
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State | LA
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Zip | 71055-3216
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Country | US
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Telephone | 318-377-4340
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Fax | 318-377-4348
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Provider Business Mailing Address
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Address Line | PO BOX 1579
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City | MINDEN
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State | LA
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Zip | 71058-1579
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Country | US
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Telephone | 318-377-4340
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Fax | 318-377-4348
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | AMY W. THORNHILL
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Credential |
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Telephone | 318-377-4340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD024062
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License Number State | LA
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