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General NPI Number Information
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NPI Number | 1811132582
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Entity Type | Organization
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Legal Business Name | POWELL VISION CENTER, INC
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 3998 POWELL RD
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City | POWELL
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State | OH
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Zip | 43065-7662
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Country | US
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Telephone | 614-336-3727
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Fax | 614-336-9958
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Provider Business Mailing Address
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Address Line | 3998 POWELL RD
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City | POWELL
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State | OH
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Zip | 43065-7662
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Country | US
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Telephone | 614-336-3727
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Fax | 614-336-9958
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Authorized Official
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Title or Position | OWNER
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Name | DAVID MATTHEW WEBSTER
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Credential | OD
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Telephone | 614-336-3727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 4391
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License Number State | OH
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