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General NPI Number Information
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NPI Number | 1932655065
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Entity Type | Organization
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Legal Business Name | METABOLIC WEIGHT LOSS CLINIC LLC
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Dates
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Enumeration Date | 08/29/2016
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 1433 E SANDUSKY ST SUITE A
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City | FINDLAY
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State | OH
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Zip | 45840-6456
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Country | US
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Telephone | 419-423-6879
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Fax | 419-423-6983
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Provider Business Mailing Address
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Address Line | 1433 E SANDUSKY ST SUITE A
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City | FINDLAY
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State | OH
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Zip | 45840-6456
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Country | US
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Telephone | 419-423-6879
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Fax | 419-423-6983
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN A ROSS
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Credential | M.D.
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Telephone | 567-278-1809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 35064459
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License Number State | OH
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