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General NPI Number Information
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NPI Number | 1821107558
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Entity Type | Organization
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Legal Business Name | VISION QUEST EYE CARE CENTER INC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 820 WALKER RD SUITE C
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City | DOVER
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State | DE
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Zip | 19904-2796
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Country | US
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Telephone | 302-678-3545
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Fax | 302-734-3115
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Provider Business Mailing Address
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Address Line | 820 WALKER RD SUITE C
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City | DOVER
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State | DE
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Zip | 19904-2796
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Country | US
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Telephone | 302-678-3545
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Fax | 302-734-3115
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MICHELE R HARANIN
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Credential | OD
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Telephone | 302-678-3545
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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 | 2001100892
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License Number State | DE
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