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General NPI Number Information
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NPI Number | 1649509571
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Entity Type | Organization
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Legal Business Name | COMPLETE FAMILY EYECARE
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Dates
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Enumeration Date | 12/24/2009
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 9755 FAIRWAY DR
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City | POWELL
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State | OH
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Zip | 43065-6947
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Country | US
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Telephone | 614-336-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 9755 FAIRWAY DR
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City | POWELL
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State | OH
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Zip | 43065-6947
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Country | US
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Telephone | 614-336-2020
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | TONI LYNN REED
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Credential | O.D.
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Telephone | 614-336-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OH 5064
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License Number State | OH
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