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General NPI Number Information
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NPI Number | 1932503240
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Entity Type | Organization
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Legal Business Name | M.A.B HEALTH SERVICES LLC
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 8500 W CAPITOL DR SUITE 201
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City | MILWAUKEE
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State | WI
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Zip | 53222-1869
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Country | US
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Telephone | 414-856-5577
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Fax |
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Provider Business Mailing Address
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Address Line | 1870 NORHARDT DR UNIT D
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City | BROOKFIELD
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State | WI
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Zip | 53045-5094
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Country | US
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Telephone | 414-915-2153
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTHONY LOUIS HALE
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Credential | DNP, FNP-BC
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Telephone | 414-915-2153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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