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General NPI Number Information
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NPI Number | 1740005495
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Entity Type | Organization
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Legal Business Name | FAMILY VISION CARE LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 4801 W BETHEL AVE
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City | MUNCIE
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State | IN
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Zip | 47304-5510
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Country | US
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Telephone | 765-288-7744
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Fax | 765-282-0741
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Provider Business Mailing Address
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Address Line | 4801 W BETHEL AVE
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City | MUNCIE
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State | IN
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Zip | 47304-5510
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Country | US
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Telephone | 765-288-7744
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Fax | 765-282-0741
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Authorized Official
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Title or Position | GM
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Name | MRS. NICOLE LEANNE VAUGHN
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Credential |
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Telephone | 765-288-7744
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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 |
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License Number State |
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