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General NPI Number Information
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NPI Number | 1740815299
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Entity Type | Organization
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Legal Business Name | PAIN AND NEUROPATHY CENTERS, LLC
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 3555 US HIGHWAY 93 N
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City | KALISPELL
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State | MT
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Zip | 59901-6815
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Country | US
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Telephone | 406-883-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 420 1ST ST E
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City | POLSON
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State | MT
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Zip | 59860-2106
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Country | US
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Telephone | 406-883-4325
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Fax |
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Authorized Official
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Title or Position | OWNER, AUTHORIZED OFFICIAL
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Name | KATHLEEN E CARTER
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Credential | ND
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Telephone | 406-883-4325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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