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General NPI Number Information
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NPI Number | 1891317780
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Entity Type | Organization
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Legal Business Name | COMPLETE MEN'S HEALTHCARE LLC
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Dates
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Enumeration Date | 05/13/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 7150 E CAMELBACK RD STE 444
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-1257
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Country | US
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Telephone | 725-780-1316
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Fax |
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Provider Business Mailing Address
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Address Line | 1930 VILLAGE CENTER CIR STE 3-104
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City | LAS VEGAS
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State | NV
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Zip | 89134-6299
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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 | MANAGER
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Name | KELLEY LIVELY
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Credential |
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Telephone | 702-400-3145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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