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General NPI Number Information
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NPI Number | 1215464680
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Entity Type | Individual
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Provider Name | AMY S VAIL
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Gender | Female
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 14555 LEVAN RD. SUITE 116
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City | LIVONIA
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State | MI
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Zip | 48154
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Country | US
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Telephone | 734-853-1510
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Fax |
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Provider Business Mailing Address
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Address Line | 22223 CASCADE DR.
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City | NOVI
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State | MI
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Zip | 48375
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Country | US
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Telephone | 734-502-7918
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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