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General NPI Number Information
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NPI Number | 1346771029
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Entity Type | Organization
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Legal Business Name | STRIDE PROSTHETICS LLC
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Dates
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Enumeration Date | 03/23/2017
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 6319 E US HIGHWAY 36 STE 203
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City | AVON
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State | IN
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Zip | 46123-6210
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Country | US
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Telephone | 317-526-4700
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Fax | 888-508-6271
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Provider Business Mailing Address
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Address Line | PO BOX 611
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City | FLATWOODS
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State | KY
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Zip | 41139-0611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. NICHOLAS WHEELER
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Credential | BOCP, LP
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Telephone | 606-585-4996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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