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General NPI Number Information
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NPI Number | 1679887913
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Entity Type | Individual
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Provider Name | LAURIE A. MITCHELL L.AC
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Gender | Female
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 360 PARRISH ST THOMPSON PROFESSIONAL BUILDING
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City | CANANDAIGUA
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State | NY
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Zip | 14424-1789
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Country | US
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Telephone | 585-396-6679
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Fax |
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Provider Business Mailing Address
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Address Line | 351 THISTLE ST
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City | BELLONA
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State | NY
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Zip | 14415-9703
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Country | US
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Telephone | 315-729-1785
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Fax | 585-526-1095
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25004385
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License Number State | NY
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