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General NPI Number Information
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NPI Number | 1639520026
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Entity Type | Organization
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Legal Business Name | REGAL ORTHOTIC SOLUTIONS, LLC
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 1108 S BROAD ST STE A
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City | SCOTTSBORO
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State | AL
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Zip | 35768-2514
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Country | US
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Telephone | 256-594-1799
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Fax | 256-594-1797
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Provider Business Mailing Address
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Address Line | PO BOX 396
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City | SCOTTSBORO
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State | AL
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Zip | 35768-0396
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Country | US
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Telephone | 256-594-1799
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Fax | 256-594-1797
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MS. AMANDA S. STEWART
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Credential |
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Telephone | 256-594-1799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1674
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License Number State | AL
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