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General NPI Number Information
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NPI Number | 1447958962
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Entity Type | Organization
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Legal Business Name | COMPLETE HEALTHCARE LLC
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 509 SOUTH BYP
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City | KENNETT
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State | MO
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Zip | 63857-3248
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Country | US
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Telephone | 870-243-4650
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1246
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City | JONESBORO
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State | AR
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Zip | 72403-1246
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE
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Name | CHRISTOPHER PRATHER
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Credential |
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Telephone | 573-559-2339
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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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