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General NPI Number Information
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NPI Number | 1437651882
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Entity Type | Organization
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Legal Business Name | MW WELLNESS VENTURES II, LLC
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 80 LAMBERT LIND HWY
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City | WARWICK
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State | RI
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Zip | 02886-1071
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Country | US
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Telephone | 401-739-7900
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Fax | 401-739-7910
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Provider Business Mailing Address
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Address Line | 80 LAMBERT LIND HWY
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City | WARWICK
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State | RI
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Zip | 02886-1071
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Country | US
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Telephone | 401-739-7900
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Fax | 401-739-7910
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Authorized Official
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Title or Position | MANAGER
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Name | JODI DESPOY
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Credential |
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Telephone | 813-228-6334
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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 |
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License Number State |
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