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General NPI Number Information
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NPI Number | 1962065672
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Entity Type | Organization
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Legal Business Name | SUMMIT FAMILY VISION LLC
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Dates
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Enumeration Date | 04/17/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 3265 W MARKET ST
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City | FAIRLAWN
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State | OH
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Zip | 44333-3337
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Country | US
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Telephone | 330-836-2200
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Fax | 866-425-2239
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Provider Business Mailing Address
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Address Line | PO BOX 880
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City | HUDSON
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State | OH
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Zip | 44236-5880
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Country | US
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Telephone | 330-697-4748
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Fax | 866-425-2239
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Authorized Official
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Title or Position | PRSIDENT
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Name | DR. RICHARD E HULTS
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Credential | OD
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Telephone | 330-697-4748
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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 |
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License Number State |
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