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General NPI Number Information
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NPI Number | 1245361658
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Entity Type | Organization
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Legal Business Name | FAMILY VISION CARE LLC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 300 9TH ST
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City | HENDERSON
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State | KY
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Zip | 42420-2751
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Country | US
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Telephone | 270-827-8681
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Fax | 270-826-7687
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Provider Business Mailing Address
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Address Line | 300 9TH ST
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City | HENDERSON
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State | KY
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Zip | 42420-2751
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Country | US
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Telephone | 270-827-8681
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Fax | 270-826-7687
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Authorized Official
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Title or Position | OWNER
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Name | SALLY M FIFE
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Credential | OD
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Telephone | 270-827-8681
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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 |
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License Number State |
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