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General NPI Number Information
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NPI Number | 1831388842
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Entity Type | Organization
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Legal Business Name | TROY WOMENS HEALTH CARE LLC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 25 PROSPECT CIRCLE
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City | TROY
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State | MO
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Zip | 63379
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Country | US
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Telephone | 636-528-2650
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Fax | 636-528-2661
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Provider Business Mailing Address
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Address Line | PO BOX 248 25 PROSPECT CIRCLE
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City | TROY
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State | MO
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Zip | 63379
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Country | US
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Telephone | 636-528-2650
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Fax | 636-528-2661
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Authorized Official
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Title or Position | PHYSICIAN
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Name | BETH RASMUSSEN
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Credential | D.O.
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Telephone | 636-528-2650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 2004015919
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License Number State | MO
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