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General NPI Number Information
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NPI Number | 1801511761
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Entity Type | Organization
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Legal Business Name | VIRTUAL EYECARE PLLC
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 2101 2ND AVE SE
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City | CAMBRIDGE
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State | MN
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Zip | 55008-4137
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Country | US
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Telephone | 763-689-2578
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 300
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City | VICTORIA
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State | MN
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Zip | 55386-0300
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Country | US
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Telephone | 952-201-2707
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Fax | 952-443-2387
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. SCOTT D HADDEN
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Credential | OD
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Telephone | 952-201-2707
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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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