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General NPI Number Information
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NPI Number | 1629902390
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Entity Type | Organization
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Legal Business Name | SOPHIE LOE THERAPEUTICS, PLLC
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Dates
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Enumeration Date | 06/09/2026
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Last Update Date | 06/09/2026
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Provider Practice Location Address
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Address Line | 599 PROVINCE RD.
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City | STRAFFORD
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State | NH
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Zip | 03884
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Country | US
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Telephone | 339-333-0960
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Fax |
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Provider Business Mailing Address
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Address Line | 134 EAST ST
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City | CARLISLE
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State | MA
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Zip | 01741-1105
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Country | US
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Telephone | 339-333-0960
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REAGAN LYNN GAGNON
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Credential | PA-C
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Telephone | 415-509-4237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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