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General NPI Number Information
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NPI Number | 1679991517
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Entity Type | Individual
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Provider Name | BOYER COLE ND
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Gender | Male
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 03/28/2014
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Provider Practice Location Address
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Address Line | 25A SAN ANSELMO AVE
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City | SAN ANSELMO
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State | CA
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Zip | 94960-2842
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Country | US
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Telephone | 415-721-7453
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Fax | 415-721-7454
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Provider Business Mailing Address
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Address Line | 25A SAN ANSELMO AVE
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City | SAN ANSELMO
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State | CA
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Zip | 94960-2842
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Country | US
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Telephone | 415-721-7453
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Fax | 415-721-7454
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND-63
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License Number State | CA
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