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General NPI Number Information
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NPI Number | 1154612232
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Entity Type | Organization
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Legal Business Name | CEDAR HEALTH CENTER
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 04/25/2011
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Provider Practice Location Address
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Address Line | 2530 E 7TH AVE
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-3719
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Country | US
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Telephone | 928-774-7165
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Fax | 928-268-3536
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Provider Business Mailing Address
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Address Line | 2530 E 7TH AVE
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-3719
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Country | US
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Telephone | 928-774-7165
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Fax | 928-268-3536
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRUCE B LEE
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Credential | DC
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Telephone | 928-774-7165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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