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General NPI Number Information
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NPI Number | 1164878476
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Entity Type | Individual
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Provider Name | WAYNE SPENCE NMD
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Gender | Male
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 7595 E MCDONALD DR SUITE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-6004
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Country | US
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Telephone | 480-274-7256
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Fax | 480-654-6217
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Provider Business Mailing Address
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Address Line | 4038 E HUBER ST
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City | MESA
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State | AZ
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Zip | 85205-4022
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Country | US
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Telephone | 480-654-6217
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Fax | 480-654-6217
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 08-1086
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License Number State | AZ
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