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General NPI Number Information
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NPI Number | 1710119664
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Entity Type | Organization
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Legal Business Name | CENTERS FOR ADVANCED VEIN CARE OF MONTANA PLLC
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 1417 9TH ST S STE 201
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City | GREAT FALLS
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State | MT
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Zip | 59405-4509
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Country | US
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Telephone | 406-727-8346
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 30212
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City | BILLINGS
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State | MT
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Zip | 59107-0212
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Country | US
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Telephone | 406-727-8346
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL B ORCUTT
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Credential |
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Telephone | 406-727-8346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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