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General NPI Number Information
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NPI Number | 1386576619
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Entity Type | Individual
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Provider Name | HOLLY CORYN SALLEE OD
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Gender | Female
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Dates
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Enumeration Date | 06/01/2026
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 711 N RIVER DR
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City | MARION
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State | IN
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Zip | 46952-2672
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Country | US
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Telephone | 765-664-9637
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Fax |
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Provider Business Mailing Address
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Address Line | 7564 W HARMONY DR
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City | ELWOOD
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State | IN
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Zip | 46036-9028
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Country | US
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Telephone | 765-810-4875
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 18004659A
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License Number State | IN
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