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General NPI Number Information
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NPI Number | 1275585739
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Entity Type | Organization
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Legal Business Name | PAR WELLNESS CORPORATION
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1221 JOHNSON AVE SUITE 1100
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City | BRIDGEPORT
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State | WV
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Zip | 26330-1392
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Country | US
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Telephone | 304-848-0338
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 JOHNSON AVE SUITE 1100
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City | BRIDGEPORT
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State | WV
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Zip | 26330-1392
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Country | US
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Telephone | 304-848-0338
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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. ROBERT PAUL ROMANO
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Credential | DO
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Telephone | 304-848-0338
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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 | 1675
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License Number State | WV
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