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General NPI Number Information
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NPI Number | 1174067847
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Entity Type | Organization
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Legal Business Name | COMPLETE VISON CARE CENTER LLC
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Dates
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Enumeration Date | 12/14/2016
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 14100 N NORTHSIGHT BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3628
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Country | US
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Telephone | 480-443-1150
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Fax | 480-443-7393
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Provider Business Mailing Address
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Address Line | 14100 N NORTHSIGHT BLVD
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-3628
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Country | US
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Telephone | 480-443-1150
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Fax | 480-443-7393
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. ANNETTE LEIGH HANIAN
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Credential | OD
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Telephone | 480-443-1150
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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 |
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License Number State |
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