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General NPI Number Information
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NPI Number | 1376258103
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Entity Type | Organization
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Legal Business Name | ROGUE VALLEY ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 845 NE 7TH ST
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City | GRANTS PASS
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State | OR
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Zip | 97526-1634
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Country | US
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Telephone | 541-218-8603
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Fax | 541-295-8235
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Provider Business Mailing Address
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Address Line | 845 NE 7TH ST
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City | GRANTS PASS
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State | OR
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Zip | 97526-1634
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Country | US
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Telephone | 541-218-8603
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Fax | 541-295-8235
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAWN R HARRIS
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Credential | DACM, L.AC.
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Telephone | 541-218-8603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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