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General NPI Number Information
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NPI Number | 1902145519
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Entity Type | Organization
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Legal Business Name | STEVENS POINT EYE CARE, LLC
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 1324 CENTERPOINT DR
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City | STEVENS POINT
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State | WI
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Zip | 54481-2807
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Country | US
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Telephone | 715-341-5088
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Fax | 715-341-5094
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Provider Business Mailing Address
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Address Line | 1324 CENTERPOINT DR
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City | STEVENS POINT
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State | WI
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Zip | 54481-2807
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Country | US
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Telephone | 715-341-5088
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Fax | 715-341-5094
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | AMANDA B HOFFMANN
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Credential | OD
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Telephone | 715-341-5088
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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 | 3190
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License Number State | WI
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