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General NPI Number Information
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NPI Number | 1386749083
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Entity Type | Individual
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Provider Name | BRUCE ALAN VASILOFF OD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2500 TIFFIN AVE
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City | FINDLAY
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State | OH
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Zip | 45840
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Country | US
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Telephone | 419-425-2125
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Fax | 419-425-3936
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Provider Business Mailing Address
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Address Line | 300 PENBROOKE DR
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City | FINDLAY
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State | OH
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Zip | 45840
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Country | US
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Telephone | 419-427-1208
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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 | 3772T1192
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 787
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License Number State | SC
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