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General NPI Number Information
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NPI Number | 1770066490
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Entity Type | Individual
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Provider Name | AMANDA PAIGE OD
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Gender | Female
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Dates
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Enumeration Date | 09/09/2018
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 4 GARDEN CTR STE 100
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City | BROOMFIELD
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State | CO
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Zip | 80020-7090
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Country | US
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Telephone | 303-469-1941
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Fax | 303-469-6634
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Provider Business Mailing Address
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Address Line | 8614 WESTWOOD CENTER DR FL 9
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City | VIENNA
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State | VA
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Zip | 22182-2442
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Country | US
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Telephone | 703-847-8899
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Fax | 571-223-6780
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 34067TLG
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.0003546
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License Number State | CO
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