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General NPI Number Information
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NPI Number | 1366469397
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Entity Type | Organization
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Legal Business Name | STRAND REGIONAL SPECIALTY
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 3617 CASEY ST SUITE D
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City | LORIS
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State | SC
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Zip | 29569-2981
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Country | US
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Telephone | 834-756-9729
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Fax | 843-390-0038
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Provider Business Mailing Address
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Address Line | PO BOX 100523
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City | FLORENCE
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State | SC
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Zip | 29501-0523
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Country | US
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Telephone | 843-669-5162
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Fax | 843-667-4573
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KIM SMITH
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Credential |
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Telephone | 843-692-2167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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