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General NPI Number Information
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NPI Number | 1932417870
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Entity Type | Organization
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Legal Business Name | WEST COUNTY EYE CARE LLC
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/20/2010
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Provider Practice Location Address
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Address Line | 23 STONEGATE CTR
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City | MANCHESTER
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State | MO
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Zip | 63088-1215
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Country | US
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Telephone | 636-225-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 23 STONEGATE CTR
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City | MANCHESTER
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State | MO
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Zip | 63088-1215
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Country | US
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Telephone | 636-225-9300
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. STEPHEN HARING
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Credential | O.D.
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Telephone | 636-225-9300
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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 | TO2872
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License Number State | MO
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