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NPI 1477072924

NPI 1477072924 : BILL BRODY RINK : JOPLIN, MO

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General NPI Number Information
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    NPI Number           |    1477072924
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    Entity Type          |    Individual 
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    Provider Name        |    BILL BRODY RINK
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/15/2017
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    Last Update Date     |    07/21/2022
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Provider Practice Location Address
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    Address Line         |    2640 E 32ND ST STE 11 
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    City                 |    JOPLIN
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    State                |    MO
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    Zip                  |    64804-4311
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    Country              |    US
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    Telephone            |    417-553-0727
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    Fax                  |    417-553-3478
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Provider Business Mailing Address
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    Address Line         |    2640 E 32ND ST STE 11 
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    City                 |    JOPLIN
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    State                |    MO
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    Zip                  |    64804-4311
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    Country              |    US
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    Telephone            |    417-553-0727
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    Fax                  |    417-553-3478
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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        |    237700000X
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    Taxonomy Name        |    Hearing Instrument Specialist
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    License Number       |    001105
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    License Number State |    OK
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Taxonomy #2
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    Taxonomy Code        |    237700000X
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    Taxonomy Name        |    Hearing Instrument Specialist
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    License Number       |    2015039402
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    License Number State |    MO
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