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General NPI Number Information
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NPI Number | 1437306370
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Entity Type | Organization
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Legal Business Name | ANOINTED HANDS MEDICAL SERVICE
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 08/21/2008
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Provider Practice Location Address
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Address Line | 1215 TUSCANY DR STE A
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City | BRASELTON
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State | GA
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Zip | 30517-3488
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Country | US
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Telephone | 770-508-8931
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | DUDLEY
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State | GA
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Zip | 31022-0218
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Country | US
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Telephone | 770-508-8931
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CYNTHIA ANN RICHARDSON
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Credential |
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Telephone | 770-508-8931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 060976
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License Number State | GA
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