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NPI 1871373530

NPI 1871373530 : BRIGHT INTEGRATIVE CARE : GLEN ALLEN, VA

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General NPI Number Information
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    NPI Number           |    1871373530
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    Entity Type          |    Organization 
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    Legal Business Name  |    BRIGHT INTEGRATIVE CARE 
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Dates
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    Enumeration Date     |    10/02/2023
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    Last Update Date     |    12/27/2023
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Provider Practice Location Address
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    Address Line         |    11551 NUCKOLS RD STE P 
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    City                 |    GLEN ALLEN
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    State                |    VA
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    Zip                  |    23059-5565
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    Country              |    US
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    Telephone            |    703-582-6433
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2688 
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    City                 |    GLEN ALLEN
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    State                |    VA
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    Zip                  |    23058-2688
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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    |    DOCTOR OF NURSE PRACTICE
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    Name                 |     MANJIT  SANGHA 
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    Credential           |    DNP
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    Telephone            |    703-582-6433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    
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    License Number State |    
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