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General NPI Number Information
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NPI Number | 1851643993
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Entity Type | Organization
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Legal Business Name | MVP VISION LLC
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Dates
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Enumeration Date | 10/14/2012
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 1180 FALL RIVER AVE WALMART VISION CENTER
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City | SEEKONK
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State | MA
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Zip | 02771
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Country | US
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Telephone | 508-336-5115
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Fax | 508-336-6913
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Provider Business Mailing Address
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Address Line | PO BOX 8429
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City | CRANSTON
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State | RI
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Zip | 02920-0429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL V PETERS
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Credential | OD
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Telephone | 508-336-5115
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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 | ODTG00539
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License Number State | RI
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