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General NPI Number Information
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NPI Number | 1275311359
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Entity Type | Organization
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Legal Business Name | CLARKSON MOBILITY 24/7/365 LLC.
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 5316 REO AVE
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City | SOUTH BEND
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State | IN
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Zip | 46619-1341
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Country | US
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Telephone | 574-343-9969
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Fax |
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Provider Business Mailing Address
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Address Line | 5316 REO AVE
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City | SOUTH BEND
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State | IN
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Zip | 46619-1341
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Country | US
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Telephone | 574-343-9969
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MARSHALL SHAUN EMORY CLARKSON
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Credential | OWNER
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Telephone | 574-387-9160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343800000X
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Taxonomy Name | Secured Medical Transport (VAN)
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License Number |
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License Number State |
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