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General NPI Number Information
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NPI Number | 1932598976
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Entity Type | Organization
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Legal Business Name | RANGER VASCULAR AND VEIN CENTER PLLC
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 01/24/2015
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Provider Practice Location Address
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Address Line | 1225 W FRONT ST SUITE B
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2368
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Country | US
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Telephone | 231-360-1775
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Fax | 231-486-6067
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Provider Business Mailing Address
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Address Line | 1225 W FRONT ST SUITE B
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-2368
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Country | US
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Telephone | 231-360-1775
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM RANGER
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Credential | M.D.
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Telephone | 231-360-1775
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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 | E5524D
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License Number State | MI
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