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General NPI Number Information
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NPI Number | 1629553177
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Entity Type | Organization
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Legal Business Name | DYLANICK, LLC
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Dates
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Enumeration Date | 10/01/2018
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Last Update Date | 10/01/2018
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Provider Practice Location Address
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Address Line | 24600 CENTER RIDGE RD STE 143
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City | WESTLAKE
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State | OH
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Zip | 44145-5617
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Country | US
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Telephone | 440-772-4017
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Fax | 440-827-2175
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Provider Business Mailing Address
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Address Line | 24600 CENTER RIDGE RD STE 143
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City | WESTLAKE
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State | OH
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Zip | 44145-5617
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Country | US
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Telephone | 440-772-4017
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Fax | 440-827-2175
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Authorized Official
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Title or Position | OWNER
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Name | GEOFF MYERS
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Credential |
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Telephone | 440-772-4017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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