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General NPI Number Information
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NPI Number | 1225125214
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Entity Type | Individual
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Provider Name | LINDA FAYE LELAND OD
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Gender | Female
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5321 S TELEGRAPH RD
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-2031
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Country | US
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Telephone | 313-292-7770
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Fax |
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Provider Business Mailing Address
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Address Line | 403 SHORE CLUB DR
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1557
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Country | US
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Telephone | 586-777-3712
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002885
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License Number State | MI
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