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General NPI Number Information
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NPI Number | 1104472992
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Entity Type | Organization
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Legal Business Name | OPTIM CARE CENTER LLC
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Dates
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Enumeration Date | 08/16/2019
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Last Update Date | 02/06/2020
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Provider Practice Location Address
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Address Line | 21931 E 9 MILE RD
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2906
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Country | US
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Telephone | 586-533-2622
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Fax |
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Provider Business Mailing Address
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Address Line | 21931 E 9 MILE RD
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2906
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMAN AFROZ
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Credential |
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Telephone | 586-533-2622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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