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General NPI Number Information
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NPI Number | 1750785606
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Entity Type | Organization
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Legal Business Name | VALLEYVIEW FAMILY CARE LLC
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 13839 S MUR LEN RD SUITE H
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City | OLATHE
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State | KS
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Zip | 66062-1685
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Country | US
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Telephone | 913-839-8614
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Fax |
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Provider Business Mailing Address
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Address Line | 13839 S MUR LEN RD SUITE H
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City | OLATHE
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State | KS
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Zip | 66062-1685
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Country | US
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Telephone | 913-839-8614
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Fax | 913-839-8615
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SHALAUNDA KAYE GRAY
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Credential | MD
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Telephone | 913-839-8614
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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 | 0430824
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License Number State | KS
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