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General NPI Number Information
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NPI Number | 1497974000
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Entity Type | Individual
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Provider Name | CARRIE ANN SMITH L.AC.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 412 E MAIN ST SUITE # E
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City | GRASS VALLEY
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State | CA
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Zip | 95945-6533
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Country | US
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Telephone | 530-273-8471
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 691
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City | GRASS VALLEY
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State | CA
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Zip | 95945
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Country | US
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Telephone | 530-273-8471
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 10164
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License Number State | CA
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