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General NPI Number Information
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NPI Number | 1669742219
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Entity Type | Organization
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Legal Business Name | HARTMAN VISION CARE LLC
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 4200 DILLON DR
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City | PUEBLO
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State | CO
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Zip | 81008-2113
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Country | US
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Telephone | 719-696-0505
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Fax | 719-884-1319
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Provider Business Mailing Address
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Address Line | PO BOX 7637
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City | PUEBLO WEST
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State | CO
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Zip | 81007-0637
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Country | US
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Telephone | 215-715-5092
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Fax | 719-884-1319
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH HARTMAN
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Credential | OD
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Telephone | 215-715-5092
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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 | OPT2783
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License Number State | CO
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