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General NPI Number Information
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NPI Number | 1194834143
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Entity Type | Organization
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Legal Business Name | WALTER WOLOSIANSKY
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 4700 MASSILLON RD
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City | NORTH CANTON
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State | OH
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Zip | 44720-1166
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Country | US
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Telephone | 330-896-9119
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Fax | 330-896-1185
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Provider Business Mailing Address
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Address Line | PO BOX 667
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City | GREEN
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State | OH
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Zip | 44232-0667
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Country | US
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Telephone | 330-896-9119
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Fax | 330-896-1185
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Authorized Official
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Title or Position | OWNER AUDIOLOGIST
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Name | MR. WALTER B WOLOSIANSKY
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Credential | MA CCC A
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Telephone | 330-896-9119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A00655
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License Number State | OH
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