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General NPI Number Information
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NPI Number | 1174920748
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Entity Type | Organization
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Legal Business Name | MONROE VISION SOURCE, PLC
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 750 STEWART RD
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City | MONROE
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State | MI
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Zip | 48162-4291
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Country | US
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Telephone | 734-242-8630
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Fax |
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Provider Business Mailing Address
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Address Line | 750 STEWART RD
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City | MONROE
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State | MI
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Zip | 48162-4291
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Country | US
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Telephone | 734-242-5157
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES D HARDIE
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Credential | O.D.
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Telephone | 734-212-5157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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