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NPI 1902939846

NPI 1902939846 : JENNIFER LEE SERIG RPH : DAYTON, TN

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General NPI Number Information
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    NPI Number           |    1902939846
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER LEE SERIG RPH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/13/2007
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    Last Update Date     |    01/15/2021
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Provider Practice Location Address
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    Address Line         |    420 MARKET ST UNIT 3 
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    City                 |    DAYTON
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    State                |    TN
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    Zip                  |    37321-1639
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    Country              |    US
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    Telephone            |    423-570-0325
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    Fax                  |    423-775-1837
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Provider Business Mailing Address
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    Address Line         |    420 MARKET ST UNIT 3 
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    City                 |    DAYTON
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    State                |    TN
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    Zip                  |    37321-1639
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    Country              |    US
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    Telephone            |    423-570-0325
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    Fax                  |    423-775-1837
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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        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    PS28170
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    License Number State |    FL
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