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General NPI Number Information
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NPI Number | 1770525164
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Entity Type | Organization
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Legal Business Name | ACCESS NUTRITION LLC
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 103 E CENTER ST SUITE 6
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City | MEBANE
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State | NC
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Zip | 27302-2431
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Country | US
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Telephone | 919-304-9561
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Fax | 919-304-9562
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Provider Business Mailing Address
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Address Line | 103B E CENTER ST SUITE 6
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City | MEBANE
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State | NC
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Zip | 27302-2431
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Country | US
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Telephone | 919-304-9561
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Fax | 919-304-9562
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Authorized Official
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Title or Position | REGISTERED DIETITIAN OWNER
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Name | LINDA ROCAFORT
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Credential | MPH RD LDN
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Telephone | 919-304-9561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | L002807
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License Number State | NC
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