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General NPI Number Information
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NPI Number | 1205156031
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Entity Type | Organization
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Legal Business Name | SUMMIT FAMILY EYE CARE LLC
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 5198 N SUMMIT ST
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City | TOLEDO
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State | OH
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Zip | 43611-2748
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Country | US
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Telephone | 419-726-1541
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Fax | 419-726-7222
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Provider Business Mailing Address
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Address Line | 5198 N SUMMIT ST
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City | TOLEDO
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State | OH
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Zip | 43611-2748
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Country | US
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Telephone | 419-726-1541
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Fax | 419-726-7222
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Authorized Official
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Title or Position | PARTNER
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Name | GAIL SANDERSON
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Credential | OD
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Telephone | 419-726-1541
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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 | 5414
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License Number State | OH
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