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General NPI Number Information
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NPI Number | 1841327111
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Entity Type | Organization
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Legal Business Name | KAREN LEE LEYDE
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 03/02/2010
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Provider Practice Location Address
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Address Line | 6575 CAHILL AVE STE 101
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-2065
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Country | US
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Telephone | 651-451-1100
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Fax | 651-451-3939
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Provider Business Mailing Address
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Address Line | 6575 CAHILL AVE STE 101
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-2065
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Country | US
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Telephone | 651-451-1100
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Fax | 651-451-3939
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KAREN LEE LEYDE
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Credential |
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Telephone | 651-451-1100
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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 |
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License Number State |
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