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General NPI Number Information
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NPI Number | 1841220910
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Entity Type | Organization
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Legal Business Name | ALLIED HEALTHCARE, LLC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 677 S WOODRUFF AVE
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City | IDAHO FALLS
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State | ID
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Zip | 83401-5596
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Country | US
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Telephone | 208-552-6200
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Fax | 208-523-7737
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Provider Business Mailing Address
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Address Line | 677 S WOODRUFF AVE
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City | IDAHO FALLS
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State | ID
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Zip | 83401-5596
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Country | US
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Telephone | 208-552-6200
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Fax | 208-523-7737
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. JASON PARKER
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Credential | D.C.
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Telephone | 208-552-6200
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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 |
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License Number State |
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