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General NPI Number Information
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NPI Number | 1811122021
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Entity Type | Organization
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Legal Business Name | TRU HEALTH CENTER
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 247 W 12300 S 1 B
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City | DRAPER
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State | UT
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Zip | 84020-9560
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Country | US
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Telephone | 801-631-9902
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Fax | 801-553-1560
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Provider Business Mailing Address
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Address Line | 247 W 12300 S 1 B
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City | DRAPER
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State | UT
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Zip | 84020-9560
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Country | US
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Telephone | 801-631-9902
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Fax | 801-553-1560
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DANIEL THOMPSON
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Credential | M.D.
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Telephone | 801-254-0309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 73368270142
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License Number State | UT
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