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General NPI Number Information
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NPI Number | 1922182286
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Entity Type | Organization
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Legal Business Name | NCH RESIDENCY CLINIC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 716 SPRING AVE NE WISE PROFESSIONAL OFFICE BLDG
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City | WISE
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State | VA
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Zip | 24293-5702
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Country | US
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Telephone | 276-328-3394
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Fax | 276-328-3396
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Provider Business Mailing Address
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Address Line | 96 15TH ST NW SUITE 104
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City | NORTON
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State | VA
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Zip | 24273-1620
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Country | US
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Telephone | 276-679-8890
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Fax | 276-679-9740
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Authorized Official
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Title or Position | PRACTICE MANAGER, CPSC
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Name | JANE STURGILL
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Credential |
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Telephone | 276-679-8890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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