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General NPI Number Information
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NPI Number | 1306027958
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Entity Type | Organization
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Legal Business Name | LOGAN EYE CARE LLC
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 560 RINEHART RD SUITE 100
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City | LAKE MARY
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State | FL
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Zip | 32746-4897
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Country | US
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Telephone | 407-333-7333
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Fax | 407-333-7313
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Provider Business Mailing Address
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Address Line | 560 RINEHART RD SUITE 100
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City | LAKE MARY
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State | FL
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Zip | 32746-4897
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Country | US
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Telephone | 407-333-7333
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Fax | 407-333-7313
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. CAROL ARMSTRONG LOGAN
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Credential | O.D.
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Telephone | 407-333-7333
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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 | OPC2262
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License Number State | FL
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