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General NPI Number Information
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NPI Number | 1902471758
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Entity Type | Individual
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Provider Name | CARLI JO HAYS
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Gender | Female
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 1325 QUEENS CT STE G
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City | SAINT PETERS
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State | MO
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Zip | 63376-7375
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Country | US
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Telephone | 636-441-8010
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Fax | 636-441-5128
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Provider Business Mailing Address
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Address Line | 1324 CLARKSON CLAYTON CTR STE 335
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City | ELLISVILLE
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State | MO
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Zip | 63011-2145
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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 |
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Name |
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Credential |
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Telephone |
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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 | 2021020743
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License Number State | MO
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