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General NPI Number Information
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NPI Number | 1366640450
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Entity Type | Organization
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Legal Business Name | JASON D MUNITZ OD LLC
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 01/09/2017
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Provider Practice Location Address
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Address Line | 295 BUCK RD SUITE 316
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City | HOLLAND
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State | PA
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Zip | 18966-1733
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Country | US
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Telephone | 215-953-1200
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Fax | 215-953-1201
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Provider Business Mailing Address
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Address Line | 295 BUCK RD SUITE 316
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City | HOLLAND
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State | PA
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Zip | 18966-1733
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Country | US
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Telephone | 215-953-1200
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Fax | 215-953-1201
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Authorized Official
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Title or Position | DOCTOR OWNER
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Name | DR. JASON MUNITZ
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Credential | OD
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Telephone | 215-953-1200
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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 | OEG000238
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License Number State | PA
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