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General NPI Number Information
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NPI Number | 1235709015
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Entity Type | Organization
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Legal Business Name | BLUE HAIR HEALTH CARE
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 120 S CENTRAL AVE
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City | CLAYTON
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State | MO
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Zip | 63105-1705
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Country | US
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Telephone | 913-579-5695
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Fax |
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Provider Business Mailing Address
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Address Line | 20006 W 89TH ST
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City | LENEXA
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State | KS
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Zip | 66220-8240
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Country | US
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Telephone | 913-579-5695
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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. SCOTT FRANKLIN AVERY
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Credential | DO
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Telephone | 913-579-5695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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