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Showing codes 1063503423 — 1245321637
1063503423 -
LESLIE
M
KLEVAY
MD
Other Name
:
Mailing Address
:
PO BOX 6002
GRAND FORKS
ND
58206-6002
Phone
: 701-780-5000;
Fax
: ;
Practice Location Address
:
UND BOX 9037 PPT
,
, GRAND FORKS
, ND
, 58201
Practice Phone
: 701-777-0000;
Practice Fax
:
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1972694339 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
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:
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1881785244 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1699866053 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1689765042 -
DR.
DR.
OPHAS
VONGXAIBURANA
MD
Other Name
:
Mailing Address
:
201 E 5TH AVE
RANSON
WV
25438-1613
Phone
: 304-725-9794;
Fax
: 304-728-4794;
Practice Location Address
:
201 E 5TH AVE
,
, RANSON
, WV
, 25438-1613
Practice Phone
: 304-725-9794;
Practice Fax
: 304-728-4794
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1598856965 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1407947872 -
DR.
DR.
REBECCA
WAMBAUGH
SHORT
M.D.
Other Name
:
REBECCA
LYNN
WAMBAUGH
Mailing Address
:
4685 FOREST AVE STE C
CINCINNATI
OH
45212-3359
Phone
: 513-246-7000;
Fax
: ;
Practice Location Address
:
6949 GOOD SAMARITAN DR
,
, CINCINNATI
, OH
, 45247
Practice Phone
: 513-246-7000;
Practice Fax
: 513-246-8855
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1316038789 -
STEVE
A
KISSEL
MD
Other Name
:
Mailing Address
:
PO BOX 604
GREENCASTLE
IN
46135
Phone
: 765-653-4003;
Fax
: 765-653-8930;
Practice Location Address
:
1148 INDIANAPOLIS RD
,
, GREENCASTLE
, IN
, 46135
Practice Phone
: 765-653-4003;
Practice Fax
: 765-653-8930
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1134210503 -
DR.
DR.
RICHARD
ANTHONY
FASANELLO
DO
Other Name
:
Mailing Address
:
105 N MAIN AVE STE A2ND
NEWTON
NC
28658-3213
Phone
: 828-615-7376;
Fax
: ;
Practice Location Address
:
105 NORTH MAIN AVE SUITE A-2ND FLOOR
,
, NEWTON
, NC
, 28658
Practice Phone
: 828-615-7376;
Practice Fax
:
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1043301419 -
MRS.
MRS.
CATHY
LEANA
WALKER
MSN, CRRN, CDE, ARNP
Other Name
:
Mailing Address
:
15902 NW 14TH PLACE
PEMBROKE PINES
FL
33028
Phone
: 954-441-7520;
Fax
: ;
Practice Location Address
:
1201 NW 16TH STREET
,
, MIAMI
, FL
, 33125
Practice Phone
: 305-575-7000;
Practice Fax
:
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1952492324 -
WAL-MART STORES EAST, LP
Other Name
:
Mailing Address
:
702 SW 8TH ST.
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
13490 BEACH BLVD
,
, JACKSONVILLE BEACH
, FL
, 32224
Practice Phone
: 904-992-8110;
Practice Fax
:
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1861583239 -
MARIA
MAGDALENA RAMIREZ
STOCKMAN
MD
Other Name
:
MARIA
M.
RAMIREZ
Mailing Address
:
5151 E BROADWAY RD STE 107
MESA
AZ
85206-1346
Phone
: 480-290-7000;
Fax
: 602-254-6840;
Practice Location Address
:
5151 E BROADWAY RD STE 107
,
, MESA
, AZ
, 85206-1346
Practice Phone
: 480-290-7000;
Practice Fax
: 480-325-3461
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1770674145 -
MR.
MR.
DARYL
EUGENE
PAYNE
MSW/LCSW
Other Name
:
Mailing Address
:
121 TIMBER TRL
EAST HARTFORD
CT
06118-3559
Phone
: 860-594-6351;
Fax
: 860-667-6747;
Practice Location Address
:
555 WILLARD AVE
,
, NEWINGTON
, CT
, 06111-2631
Practice Phone
: 860-594-6351;
Practice Fax
: 860-667-6842
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1114018587 -
DONNA
AGEE
LPCC
Other Name
:
Mailing Address
:
259 PARKERS MILL RD
SOMERSET
KY
42501-3152
Phone
: 606-679-4782;
Fax
: 606-678-5296;
Practice Location Address
:
200 E FRAZIER AVE
,
, COLUMBIA
, KY
, 42728-1915
Practice Phone
: 270-384-4710;
Practice Fax
: 270-384-4820
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1023109493 -
MS.
MS.
ELENA
GUTU
DMD
Other Name
:
Mailing Address
:
5500 1ST AVE N
ST PETERSBURG
FL
33710-8006
Phone
: 727-954-4431;
Fax
: ;
Practice Location Address
:
5500 1ST AVE N
,
, ST PETERSBURG
, FL
, 33710-8006
Practice Phone
: 727-954-4431;
Practice Fax
:
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1932290301 -
GEORGE
WEINTRAUB
DPM
Other Name
:
Mailing Address
:
57 W 93RD ST
APT 6C
NEW YORK
NY
10025-7665
Phone
: 212-864-3619;
Fax
: 212-402-1752;
Practice Location Address
:
57 W 93RD ST
, APT 6C
, NEW YORK
, NY
, 10025-7665
Practice Phone
: 212-864-3619;
Practice Fax
: 212-402-1752
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1295826667 -
MRS.
MRS.
LATARCHA
NEKAYA
MOYE
CRT
Other Name
:
Mailing Address
:
RR 2
SOPERTON
GA
30457-9580
Phone
: 912-529-3283;
Fax
: ;
Practice Location Address
:
1826 VETERANS BLVD
,
, DUBLIN
, GA
, 31021-3620
Practice Phone
: 478-272-1210;
Practice Fax
:
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1104917574 -
MS.
MS.
BEATRICE
CARRASCO
ARRAMBIDE
WHCAPN
Other Name
:
Mailing Address
:
221 3RD ST W BLDG 1040
JBSA RANDOLPH
TX
78150-4800
Phone
: 210-652-8544;
Fax
: ;
Practice Location Address
:
221 3RD ST W BLDG 1040
,
, JBSA RANDOLPH
, TX
, 78150-4800
Practice Phone
: 210-652-8544;
Practice Fax
:
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1013008481 -
DR.
DR.
RICHARD
DERBY
JR.
MD
Other Name
:
Mailing Address
:
901 CAMPUS DRIVE
SUITE 312
DALY CITY
CA
94015
Phone
: 650-755-0733;
Fax
: 650-755-3018;
Practice Location Address
:
901 CAMPUS DRIVE
, SUITE 312
, DALY CITY
, CA
, 94015
Practice Phone
: 650-755-0733;
Practice Fax
: 650-755-3018
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1003907478 -
KAREN
C
PENROSE
NP
Other Name
:
Mailing Address
:
900 MOHAWK ST STE E
SAVANNAH
GA
31419-1768
Phone
: 912-925-0067;
Fax
: 912-927-0267;
Practice Location Address
:
900 MOHAWK ST STE E
,
, SAVANNAH
, GA
, 31419-1768
Practice Phone
: 912-925-0067;
Practice Fax
: 912-927-0267
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1730270109 -
HARRY
VASSILAKIS
DC
Other Name
:
Mailing Address
:
1040 MASON AVENUE
DAYTONA BEACH
FL
32117
Phone
: 386-248-0107;
Fax
: 386-248-0109;
Practice Location Address
:
1040 MASON AVENUE
,
, DAYTONA BEACH
, FL
, 32117
Practice Phone
: 386-248-0107;
Practice Fax
: 386-248-0109
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1811088289 -
MR.
MR.
WILLIAM
A
DUNN
RPH
Other Name
:
Mailing Address
:
710 HORATIO ST
UTICA
NY
13502-1400
Phone
: 561-707-5168;
Fax
: ;
Practice Location Address
:
710 HORATIO ST
,
, UTICA
, NY
, 13502-1400
Practice Phone
: 315-738-0759;
Practice Fax
:
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1720179195 -
HIALEAH DENTAL CARE INC
Other Name
:
Mailing Address
:
4240 WEST 16 AVE
HIALEAH
FL
33012
Phone
: 305-823-1882;
Fax
: 305-819-0275;
Practice Location Address
:
4240 WEST 16 AVE
,
, HIALEAH
, FL
, 33012
Practice Phone
: 305-823-1882;
Practice Fax
: 305-819-0275
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1639260003 -
ADA
ASENJO
Other Name
:
Mailing Address
:
101 W MUHAMMAD ALI BLVD
LOUISVILLE
KY
40202-1423
Phone
: ;
Fax
: ;
Practice Location Address
:
3717 TAYLORSVILLE RD
,
, LOUISVILLE
, KY
, 40220-1333
Practice Phone
: 502-589-1100;
Practice Fax
: 502-589-8771
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1548351919 -
MR.
MR.
JOSHUA
JOSEPH
FOSS
Other Name
:
Mailing Address
:
346 PELICAN ST
ELIZABETH CITY
NC
27909-6710
Phone
: 252-335-6460;
Fax
: ;
Practice Location Address
:
346 PELICAN ST
,
, ELIZABETH CITY
, NC
, 27909-6710
Practice Phone
: 252-335-6460;
Practice Fax
:
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1457442824 -
DR.
DR.
TIM
J
NICE
M.D.
Other Name
:
Mailing Address
:
34600 CHARDON RD
SUITE 9
WILLOUGHBY HILLS
OH
44094-8480
Phone
: 440-585-5258;
Fax
: 440-944-5278;
Practice Location Address
:
34600 CHARDON RD
, SUITE 9
, WILLOUGHBY HILLS
, OH
, 44094-8480
Practice Phone
: 440-585-5258;
Practice Fax
: 440-944-5278
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1538250907 -
KENT FAMILY DENTAL CARE
Other Name
:
Mailing Address
:
7604 WOODVALE ST SE
GRAND RAPIDS
MI
49546-9147
Phone
: 616-364-9348;
Fax
: 616-364-5950;
Practice Location Address
:
2515 ALPINE AVE NW
,
, GRAND RAPIDS
, MI
, 49544-1924
Practice Phone
: 616-364-9348;
Practice Fax
: 616-364-5950
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1447341813 -
MISS
MISS
JENNIE
A.
ABRAMS
LPC
Other Name
:
Mailing Address
:
703 THIMBLE SHOALS BLVD STE C-6
NEWPORT NEWS
VA
23606-2576
Phone
: 757-876-7194;
Fax
: ;
Practice Location Address
:
703 THIMBLE SHOALS BLVD STE C-6
,
, NEWPORT NEWS
, VA
, 23606-2576
Practice Phone
: 757-876-7194;
Practice Fax
: 757-876-7194
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1619068087 -
PHYSICAL THERAPY OF WEST GEORGIA
Other Name
:
Mailing Address
:
18601 E SILVERHILL AVE
ROBERTSDALE
AL
36567-3703
Phone
: 251-747-4188;
Fax
: 251-217-9162;
Practice Location Address
:
5422 ARMOUR RD
, #B
, COLUMBUS
, GA
, 31909
Practice Phone
: 251-747-4188;
Practice Fax
: 251-217-9162
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1528159993 -
DAVID
ISRAEL
ZUCKER
ED.D
Other Name
:
Mailing Address
:
2300 MONTANA AVE
317
CINCINNATI
OH
45211-3829
Phone
: 513-662-8200;
Fax
: 513-662-8201;
Practice Location Address
:
2300 MONTANA AVE
, 317
, CINCINNATI
, OH
, 45211-3829
Practice Phone
: 513-662-8200;
Practice Fax
: 513-662-8201
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1437240801 -
MRS.
MRS.
LEEANN
OSTROWSKI
PA
Other Name
:
Mailing Address
:
100 N ACADEMY AVE
DANVILLE
PA
17822-4903
Phone
: 570-271-6144;
Fax
: 570-271-6578;
Practice Location Address
:
1155 E MOUNTAIN BLVD
,
, WILKES BARRE
, PA
, 18702-7906
Practice Phone
: 570-808-7916;
Practice Fax
: 570-808-6006
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1346331717 -
MISS
MISS
SUSAN
M
PALMER
DO
Other Name
:
Mailing Address
:
PO BOX 416457
BOSTON
MA
02241-6457
Phone
: 844-362-1735;
Fax
: 973-290-7495;
Practice Location Address
:
714 ROUTE 10 W
,
, RANDOLPH
, NJ
, 07869-2058
Practice Phone
: 973-891-1213;
Practice Fax
: 973-891-1216
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1255422622 -
DR.
DR.
JOHN
WILLIAM
ANTONETZ
DDS
Other Name
:
Mailing Address
:
11127 GILA VALLEY DR
LITTLE ROCK
AR
72212-3505
Phone
: 501-225-9437;
Fax
: ;
Practice Location Address
:
2200 FORT ROOTS DR
,
, NORTH LITTLE ROCK
, AR
, 72114-1709
Practice Phone
: 501-257-1000;
Practice Fax
:
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1073604443 -
MR.
MR.
PATRICK
F
CIONI
MS MA
Other Name
:
Mailing Address
:
138 S CAMERON AVENUE
SCRANTON
PA
18504
Phone
: 570-343-0234;
Fax
: 570-343-0234;
Practice Location Address
:
138 S CAMERON AVENUE
,
, SCRANTON
, PA
, 18504
Practice Phone
: 570-343-0234;
Practice Fax
: 570-343-0234
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1982795357 -
CHANDRA
SHEKAR
MD
Other Name
:
Mailing Address
:
4425 N PORT WASHINGTON RD
ASCENSION CREDENTIALING
GLENDALE
WI
53212-1082
Phone
: ;
Fax
: ;
Practice Location Address
:
500 S OAKWOOD RD
,
, OSHKOSH
, WI
, 54904-7944
Practice Phone
: 920-223-2000;
Practice Fax
: 920-223-0508
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1790876167 -
MR.
MR.
GARY
BRIAN
WIELE
DDS
Other Name
:
Mailing Address
:
2821 N BALLAS RD
STE 260
ST LOUIS
MO
63131
Phone
: 314-475-5333;
Fax
: 314-475-5334;
Practice Location Address
:
2821 N BALLAS RD
, STE 260
, ST LOUIS
, MO
, 63131
Practice Phone
: 314-475-5333;
Practice Fax
: 314-475-5334
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1609967074 -
DR.
DR.
DAVID
NEAL
JACOBSEN
D.C.
Other Name
:
Mailing Address
:
755 WESTMORELAND RD
DAYTONA BEACH
FL
32114-1626
Phone
: 386-226-0011;
Fax
: 386-226-0013;
Practice Location Address
:
755 WESTMORELAND RD
,
, DAYTONA BEACH
, FL
, 32114-1626
Practice Phone
: 386-226-0011;
Practice Fax
: 386-226-0013
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1518058981 -
DR.
DR.
KATHRYN
ANN
BAMFORD
PHD
Other Name
:
Mailing Address
:
68 LASALLE PARKWAY
VICTOR
NY
14564
Phone
: 585-704-0859;
Fax
: ;
Practice Location Address
:
620 CROSS KEYS OFFICE PARK
,
, FAIRPORT
, NY
, 14450-3508
Practice Phone
: 585-223-5920;
Practice Fax
: 585-223-5727
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1427149897 -
DR.
DR.
DOUGLAS
FINLEY
WRIGHT
D.D.S, M.S.D.
Other Name
:
Mailing Address
:
288 WELLINGWOOD CT
EAST AMHERST
NY
14051-1710
Phone
: 716-688-0539;
Fax
: ;
Practice Location Address
:
3985 MAIN ST
,
, AMHERST
, NY
, 14226-3404
Practice Phone
: 716-832-1550;
Practice Fax
: 716-832-6462
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1245321611 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1154412526 -
DR.
DR.
THEODORE
CARL
HOUK
M.D.
Other Name
:
Mailing Address
:
7402 YORK ROAD
SUITE 301
TOWSON
MD
21204-7522
Phone
: 410-296-5200;
Fax
: 410-296-5263;
Practice Location Address
:
7402 YORK RD STE 301
,
, TOWSON
, MD
, 21204-7522
Practice Phone
: 410-296-5200;
Practice Fax
: 410-296-5263
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1063503431 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1871684241 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1699866079 -
SANDRA
C
JOHNSON
MD
Other Name
:
Mailing Address
:
PO BOX 255228
SACRAMENTO
CA
95865-5228
Phone
: 800-470-0071;
Fax
: ;
Practice Location Address
:
635 ANDERSON RD
, #10
, DAVIS
, CA
, 95616-3505
Practice Phone
: 530-758-1122;
Practice Fax
: 530-758-1646
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1508957986 -
VIRGINA
JOYCE
MD
Other Name
:
Mailing Address
:
PO BOX 255228
SACRAMENTO
CA
95865-5228
Phone
: 800-470-0071;
Fax
: ;
Practice Location Address
:
2030 SUTTER PL
, #1100
, DAVIS
, CA
, 95616-6201
Practice Phone
: 530-750-5890;
Practice Fax
: 530-750-5859
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1417048893 -
DR.
DR.
RYAN ROMMEL
SORIANO
GUANZON
MD
Other Name
:
Mailing Address
:
1400 E. KINCAID STREET
MOUNT VERNON
WA
98274-4127
Phone
: 360-428-2500;
Fax
: 360-428-6485;
Practice Location Address
:
110 N LAVENTURE RD STE C
,
, MOUNT VERNON
, WA
, 98273-3901
Practice Phone
: 360-814-8240;
Practice Fax
: 360-848-4502
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1326139700 -
DR.
DR.
MARIEL
CASTILLO
MD
Other Name
:
MARIEL
CASTILLO-GUANZON
Mailing Address
:
1400 E. KINCAID STREET
MOUNT VERNON
WA
98274-4127
Phone
: 360-428-2500;
Fax
: 360-428-6485;
Practice Location Address
:
2320 FREEWAY DR
,
, MOUNT VERNON
, WA
, 98273-5445
Practice Phone
: 360-814-6870;
Practice Fax
: 360-814-6871
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1235220617 -
MRS.
MRS.
KATHRYN
M.
ROMANO
NP
Other Name
:
Mailing Address
:
750 E. ADAMS STREET
SYRACUSE
NY
13210
Phone
: 315-464-8200;
Fax
: 315-464-8206;
Practice Location Address
:
750 E. ADAMS STREET
,
, SYRACUSE
, NY
, 13210
Practice Phone
: 315-464-8200;
Practice Fax
: 315-464-8206
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1144311523 -
SETH
J
BREMYER
LCPC
Other Name
:
Mailing Address
:
9626 E CLUBHOUSE CT
WICHITA
KS
67226-3656
Phone
: 620-755-8521;
Fax
: ;
Practice Location Address
:
9626 E CLUBHOUSE CT
,
, WICHITA
, KS
, 67226-3656
Practice Phone
: 620-755-8521;
Practice Fax
:
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1053402438 -
SALVATORE
GAUDINO
DPM
Other Name
:
Mailing Address
:
420 74TH ST
BROOKLYN
NY
11209-2602
Phone
: 718-836-1017;
Fax
: 718-836-9555;
Practice Location Address
:
420 74TH ST
,
, BROOKLYN
, NY
, 11209-2602
Practice Phone
: 718-836-1017;
Practice Fax
: 718-836-9555
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1962593343 -
SAM'S CLUB OPTICAL
Other Name
:
Mailing Address
:
702 SW 8TH STREET
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
2365 CRAIN HWY
,
, WALDORF
, MD
, 20601-3167
Practice Phone
: 301-645-6116;
Practice Fax
:
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1871684258 -
WAL-MART STORES EAST, LP
Other Name
:
Mailing Address
:
702 SW 8TH ST.
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
10270 FRONT BEACH RD
,
, PANAMA CITY BEACH
, FL
, 32407-3808
Practice Phone
: 850-234-1989;
Practice Fax
:
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1780775163 -
INDIANA UNIVERSITY HEALTH PROTON THERAPY CENTER, LLC
Other Name
:
Mailing Address
:
2425 MILO B. SAMPSON LANE
BLOOMINGTON
IN
47408-1398
Phone
: 812-349-5074;
Fax
: 812-349-5046;
Practice Location Address
:
2425 MILO B. SAMPSON LANE
,
, BLOOMINGTON
, IN
, 47408-1398
Practice Phone
: 812-349-5074;
Practice Fax
: 812-349-5046
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1598856973 -
SAM'S CLUB OPTICAL
Other Name
:
Mailing Address
:
702 SW 8TH STREET
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
1301 VETERANS PKWY
,
, CLARKSVILLE
, IN
, 47129-7747
Practice Phone
: 812-218-0310;
Practice Fax
:
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1407947880 -
DR.
DR.
AGUIDA
C.
ATKINSON
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
NEMOURS PEDIATRICS ST. FRANCIS
, 7TH & CLAYTON STREET SUITE 400
, WILMINGTON
, DE
, 19805-3165
Practice Phone
: 302-421-9700;
Practice Fax
: 302-421-9743
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1134210511 -
DR.
DR.
ANDREW
A.
HENDERSON
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
NEMOURS PEDIATRICS PHILADELPHIA PIKE
, 222 PHILADELPHIA PIKE
, WILMINGTON
, DE
, 19809-3166
Practice Phone
: 302-761-4660;
Practice Fax
: 302-761-4666
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1043301427 -
DR.
DR.
ANNA
KOLANO
D.O.
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
NEMOURS PEDIATRICS PEOPLES PLAZA
, 1400 PEOPLES PLAZA SUITE 300
, NEWARK
, DE
, 19702-5708
Practice Phone
: 302-836-7820;
Practice Fax
: 302-836-7826
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1952492332 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1861583247 -
DR.
DR.
ANTHONY
M.
POLICASTRO
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
NEMOURS PEDIATRICS SEAFORD
, 121 S. FRONT STREET
, SEAFORD
, DE
, 19973-3511
Practice Phone
: 302-651-4000;
Practice Fax
: 302-651-4945
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1770674152 -
DR.
DR.
AIXA
I
SILVERA-SCHWARTZ
M.D.
Other Name
:
Mailing Address
:
562 CONCORD RD SE
SMYRNA
GA
30082-2608
Phone
: 770-384-9900;
Fax
: 770-384-9912;
Practice Location Address
:
562 CONCORD ROAD SE
,
, SMYRNA
, GA
, 30082
Practice Phone
: 770-384-9900;
Practice Fax
: 770-384-9912
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1689765067 -
DR.
DR.
CAROL
A
SQUYRES
MD
Other Name
:
Mailing Address
:
PO BOX 3158
PORTLAND
OR
97208-3158
Phone
: 503-215-6900;
Fax
: ;
Practice Location Address
:
16770 SW EDY RD
, STE 102
, SHERWOOD
, OR
, 97140-9678
Practice Phone
: 503-215-9600;
Practice Fax
:
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1497846877 -
LARRY
JAMES
ALLEN
O.D.
Other Name
:
Mailing Address
:
PO BOX 680317
FORT PAYNE
AL
35968-1604
Phone
: 256-845-0231;
Fax
: ;
Practice Location Address
:
103 GRAND AVE SW
,
, FORT PAYNE
, AL
, 35967-1915
Practice Phone
: 256-845-0231;
Practice Fax
:
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1306937784 -
DR.
DR.
ASMA
SYED
Other Name
:
Mailing Address
:
1 BROOKDALE PLAZA
PHYSICIAN ENTERPRISE
BROOKLYN
NY
11212
Phone
: 718-240-7143;
Fax
: 718-240-5808;
Practice Location Address
:
1 BROOKDALE PLZ
, OBH HEART - 3 SNAPPER
, BROOKLYN
, NY
, 11212-3198
Practice Phone
: 718-240-6201;
Practice Fax
: 718-240-6618
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1215028691 -
WAL-MART STORES EAST, LP
Other Name
:
Mailing Address
:
702 SW 8TH ST.
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
1024 S STATE ROAD 19
,
, PALATKA
, FL
, 32177-9000
Practice Phone
: 386-328-6733;
Practice Fax
:
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1124119508 -
WAL-MART STORES EAST, LP
Other Name
:
Mailing Address
:
702 SW 8TH ST.
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
1619 DEL PRADO BLVD S
,
, CAPE CORAL
, FL
, 33990-3713
Practice Phone
: 239-772-9220;
Practice Fax
:
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1033200415 -
WAL-MART STORES EAST, LP
Other Name
:
Mailing Address
:
702 SW 8TH ST.
BENTONVILLE
AR
72716-0235
Phone
: ;
Fax
: ;
Practice Location Address
:
3653 S ORLANDO DR
,
, SANFORD
, FL
, 32773-5611
Practice Phone
: 407-321-1371;
Practice Fax
:
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1942391321 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1851482236 -
DR.
DR.
GERARD
A.
KUHN
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
NEMOURS PEDIATRICS MIDDLETOWN
, 200 CLEAVER FARM ROAD SUITE 201
, MIDDLETOWN
, DE
, 19709-1630
Practice Phone
: 302-378-5100;
Practice Fax
: 302-378-5106
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1760573141 -
DR.
DR.
GARY
S.
LYTLE
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
NEMOURS PEDIATRICS MIDDLETOWN
, 200 CLEAVER FARM ROAD SUITE 201
, MIDDLETOWN
, DE
, 19709-1630
Practice Phone
: 302-378-5100;
Practice Fax
: 302-378-5106
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1679664056 -
DR.
DR.
FRANCIS
J.
MONTONE
D.O.
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
NEMOURS PEDIATRICS DOVER
, 102 W. WATER STREET SUITE 1
, DOVER
, DE
, 19904-6750
Practice Phone
: 302-672-5650;
Practice Fax
: 302-672-5655
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1588755961 -
DR.
DR.
DOLORES
L
UN
MD
Other Name
:
Mailing Address
:
CORPORATE CREDENTIALING
P.O. BOX 269
WILMINGTON
DE
19899
Phone
: 302-651-5938;
Fax
: 302-651-6077;
Practice Location Address
:
NEMOURS PEDIATRICS PEOPLES PLAZA
, 1400 PEOPLES PLAZA STE. 300
, NEWARK
, DE
, 19702
Practice Phone
: 302-836-7820;
Practice Fax
: 302-836-7826
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1396836771 -
DR.
DR.
COLLEEN
R.
WITHERELL
MD
Other Name
:
Mailing Address
:
PO BOX 191
PROVIDER ENROLLMENT DEPT
ROCKLAND
DE
19732-0191
Phone
: 302-651-6212;
Fax
: 302-651-4945;
Practice Location Address
:
NEMOURS PEDIATRICS JESSUP ST.
, 1602 JESSUP STREET
, WILMINGTON
, DE
, 19802-4210
Practice Phone
: 302-576-5050;
Practice Fax
: 302-576-5065
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1205927688 -
MR.
MR.
RALPH
A
PRETE
RPH
Other Name
:
Mailing Address
:
7915 S DIXIE HWY
WEST PALM BEACH
FL
33405-4821
Phone
: 561-585-8460;
Fax
: 561-585-8770;
Practice Location Address
:
7915 S DIXIE HWY
,
, WEST PALM BEACH
, FL
, 33405-4821
Practice Phone
: 561-585-8460;
Practice Fax
: 561-585-8770
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1114018595 -
MICHELLE
L
RAAD
M.D.
Other Name
:
Mailing Address
:
240 WILLIAMSON ST STE 503
ELIZABETH
NJ
07202-3673
Phone
: 908-355-1010;
Fax
: 908-355-5629;
Practice Location Address
:
240 WILLIAMSON ST STE 503
,
, ELIZABETH
, NJ
, 07202-3673
Practice Phone
: 908-355-1010;
Practice Fax
: 908-355-5629
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1023109402 -
DR.
DR.
RICHMOND
LEMOS
D.O.
Other Name
:
Mailing Address
:
2950 ROBERTSON AVE
CINCINNATI
OH
45209-1268
Phone
: 513-281-4400;
Fax
: 513-587-8213;
Practice Location Address
:
1 WYOMING ST
,
, DAYTON
, OH
, 45409-2722
Practice Phone
: 513-281-4400;
Practice Fax
: 513-587-8213
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1932290319 -
DR.
DR.
EDUARDO
AUGUSTIN
SALVATI
M.D.
Other Name
:
Mailing Address
:
PO BOX 29234
NEW YORK
NY
10087-9234
Phone
: ;
Fax
: ;
Practice Location Address
:
535 E 70TH ST
,
, NEW YORK
, NY
, 10021-4823
Practice Phone
: 646-797-8973;
Practice Fax
:
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1841381225 -
DIANA
UGLOVA
PA-C
Other Name
:
Mailing Address
:
1400 VFW PARKWAY
VA MC (112)
WEST ROXBURY
MA
02132
Phone
: 857-203-6200;
Fax
: 857-203-5738;
Practice Location Address
:
1400 VFW PKWY
, VA MC (112)
, WEST ROXBURY
, MA
, 02132-4927
Practice Phone
: 857-203-6200;
Practice Fax
: 857-203-5738
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1750472130 -
MR.
MR.
MATT
ALLEN
SOOTER
P.T.
Other Name
:
Mailing Address
:
4350 S NATIONAL AVE
SUITE A108
SPRINGFIELD
MO
65810-2607
Phone
: 417-823-8670;
Fax
: 417-823-8625;
Practice Location Address
:
4350 S NATIONAL AVE
, SUITE A108
, SPRINGFIELD
, MO
, 65810-2607
Practice Phone
: 417-823-8670;
Practice Fax
: 417-823-8625
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1578654950 -
GRAND LAKE SLEEP CENTER
Other Name
:
Mailing Address
:
1040 HAGER ST
SAINT MARYS
OH
45885-2421
Phone
: 419-394-9992;
Fax
: 419-394-9629;
Practice Location Address
:
1040 HAGER ST
,
, SAINT MARYS
, OH
, 45885-2421
Practice Phone
: 419-394-9992;
Practice Fax
: 419-394-9629
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1487745865 -
DR.
DR.
JOHN
BRET
HOOD
M.D.
Other Name
:
Mailing Address
:
5430 FREDERICKSBURG RD
STE 200
SAN ANTONIO
TX
78229-3539
Phone
: 210-348-4012;
Fax
: ;
Practice Location Address
:
5430 FREDERICKSBURG RD
, STE 200
, SAN ANTONIO
, TX
, 78229-3539
Practice Phone
: 210-348-4012;
Practice Fax
:
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1295826675 -
MICHAEL
R.
MUSTARD
MD
Other Name
:
Mailing Address
:
1005 BROADWAY ST
QUINCY
IL
62301-2834
Phone
: 217-223-8400;
Fax
: 217-277-3960;
Practice Location Address
:
1005 BROADWAY ST
,
, QUINCY
, IL
, 62301-2834
Practice Phone
: 217-223-8400;
Practice Fax
: 217-214-5837
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1104917582 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1528159902 -
DR.
DR.
KATHLEEN
ANN
MALONE
M.D.
Other Name
:
Mailing Address
:
2950 ROBERTSON AVE
2ND FLOOR
CINCINNATI
OH
45209-1268
Phone
: 513-281-4400;
Fax
: 513-587-8213;
Practice Location Address
:
1 WYOMING ST
,
, DAYTON
, OH
, 45409-2722
Practice Phone
: 513-281-4400;
Practice Fax
: 513-587-8213
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1437240819 -
WILLIAM
D
REED
JR.
DDS
Other Name
:
Mailing Address
:
109 E LORRAINE ST
ANGLETON
TX
77515
Phone
: 979-849-1213;
Fax
: 979-848-8370;
Practice Location Address
:
109 E LORRAINE ST
,
, ANGLETON
, TX
, 77515
Practice Phone
: 979-849-1213;
Practice Fax
: 979-848-8370
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1346331725 -
PALOMA MEDICAL GROUP INC
Other Name
:
Mailing Address
:
PO BOX 7087
ORANGE
CA
92863-7087
Phone
: 714-571-5000;
Fax
: 714-571-5055;
Practice Location Address
:
30230 RANCHO VIEJO RD
, SUITE 200
, SAN JUAN CAPISTRANO
, CA
, 92675-1557
Practice Phone
: 949-443-4303;
Practice Fax
: 949-443-4033
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1255422630 -
MYSTICK WOMEN'S HEALTH, INC.
Other Name
:
Mailing Address
:
13 BRADLEE RD
MEDFORD
MA
02155-3110
Phone
: 781-395-1110;
Fax
: 781-395-8553;
Practice Location Address
:
13 BRADLEE RD
,
, MEDFORD
, MA
, 02155-3110
Practice Phone
: 781-395-1110;
Practice Fax
: 781-395-8553
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1164513545 -
DR.
DR.
INSOOK
PATTY
YANG
D.D.S.
Other Name
:
Mailing Address
:
214 E ERIE ST
MISSOURI VALLEY
IA
51555-1533
Phone
: 712-642-4136;
Fax
: 712-642-3664;
Practice Location Address
:
214 E ERIE ST
,
, MISSOURI VALLEY
, IA
, 51555-1533
Practice Phone
: 712-642-4136;
Practice Fax
: 712-642-3664
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1073604450 -
DR.
DR.
BETH
J
DUBOIS
D.C.
Other Name
:
Mailing Address
:
55 E BRIDGE ST
OSWEGO
NY
13126-2120
Phone
: 315-342-6300;
Fax
: 315-342-6302;
Practice Location Address
:
55 E BRIDGE ST
,
, OSWEGO
, NY
, 13126-2120
Practice Phone
: 315-342-6300;
Practice Fax
: 315-342-6302
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1982795365 -
CANTON PODAITRY ASSOCIATES
Other Name
:
Mailing Address
:
742 WASHINGTON ST
CANTON
MA
02021-3039
Phone
: 781-821-2696;
Fax
: 781-821-6282;
Practice Location Address
:
742 WASHINGTON ST
,
, CANTON
, MA
, 02021-3039
Practice Phone
: 781-821-2696;
Practice Fax
: 781-821-6282
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1790876175 -
MICHELLE
YOUNG
N.P.
Other Name
:
Mailing Address
:
323 LOWELL ST STE 302
ANDOVER
MA
01810-4501
Phone
: 978-475-2731;
Fax
: ;
Practice Location Address
:
323 LOWELL ST STE 302
,
, ANDOVER
, MA
, 01810-4501
Practice Phone
: 978-475-2731;
Practice Fax
:
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1609967082 -
MICHAEL
STEVEN
RAPPAPORT
MD
Other Name
:
Mailing Address
:
2051 KAEN RD
OREGON CITY
OR
97045-4035
Phone
: 503-655-8471;
Fax
: 503-655-8595;
Practice Location Address
:
998 LIBRARY CT
,
, OREGON CITY
, OR
, 97045-4041
Practice Phone
: 503-655-8401;
Practice Fax
: 503-655-8429
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1518058999 -
MS.
MS.
LYNN
RENEE
HALLOWELL-GOTTSLEBEN
PT, DPT
Other Name
:
LYNN
RENEE
HALLOWELL
Mailing Address
:
5401 SOUTH ST
LINCOLN
NE
68506-2150
Phone
: 402-483-9502;
Fax
: 402-486-8285;
Practice Location Address
:
5401 SOUTH ST
,
, LINCOLN
, NE
, 68506-2150
Practice Phone
: 402-486-7704;
Practice Fax
: 402-486-7701
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1427149806 -
MR.
MR.
MARK
ANTON
KRIPAL
MS CCCA
Other Name
:
Mailing Address
:
BOX 795
NORTH PLATTE
NE
69101-0795
Phone
: 308-532-3330;
Fax
: 308-532-6354;
Practice Location Address
:
801 WILLIAM ST
,
, NORTH PLATTE
, NE
, 69101
Practice Phone
: 308-532-3330;
Practice Fax
: 308-532-6354
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1336230713 -
GENERATIONS: COMMUNITY SUPPORT SERVICES
Other Name
:
Mailing Address
:
2649 PARK AVE S.
MINNEAPOLIS
MN
55047
Phone
: 612-676-1604;
Fax
: 612-379-8235;
Practice Location Address
:
60 MARIE AVE E
,
, SAINT PAUL
, MN
, 55118-5910
Practice Phone
: 651-552-9071;
Practice Fax
: 651-552-9874
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1245321629 -
MRS.
MRS.
STACEY
BETH
ROVINSKY
BSW,CPRP
Other Name
:
Mailing Address
:
190 WESTFORT DR
MERIDEN
CT
06451-3600
Phone
: 203-634-9264;
Fax
: ;
Practice Location Address
:
950 CAMPBELL AVE
,
, WEST HAVEN
, CT
, 06516-2770
Practice Phone
: 203-931-4010;
Practice Fax
:
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1609967090 -
CAROLYN
P
BRAINARD
LMP
Other Name
:
Mailing Address
:
1917 N LAKEWOOD DR
COEUR D ALENE
ID
83814-2634
Phone
: 208-664-8194;
Fax
: 208-667-1847;
Practice Location Address
:
1172 W HAYDEN AVE
,
, HAYDEN
, ID
, 83835-8700
Practice Phone
: 208-762-3332;
Practice Fax
: 208-762-4268
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1518058908 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1427149814 -
WHITE RIVER HEALTH SYSTEM, INC.
Other Name
:
Mailing Address
:
1710 HARRISON ST
BATESVILLE
AR
72501-7303
Phone
: 870-269-4361;
Fax
: 870-269-3093;
Practice Location Address
:
2106 E. MAIN ST.
,
, MOUNTAIN VIEW
, AR
, 72560-6439
Practice Phone
: 870-262-5056;
Practice Fax
: 870-262-6088
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1336230721 -
MR.
MR.
STEPHEN
GEORGE
DUNN
DMD
Other Name
:
Mailing Address
:
1408 EAST CARSON ST
PITTSBURGH
PA
15203
Phone
: 412-431-6631;
Fax
: 412-431-6297;
Practice Location Address
:
1408 E CARSON ST
, 145 BROWNSVILLE RD
, PITTSBURGH
, PA
, 15203
Practice Phone
: 412-431-6631;
Practice Fax
: 412-431-6297
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1245321637 -
BEATRICE
KAY
RANKIN
DC
Other Name
:
Mailing Address
:
1931 RICHMOND AVE
HOUSTON
TX
77098
Phone
: 713-526-2225;
Fax
: 713-590-0054;
Practice Location Address
:
1931 RICHMOND AVE
,
, HOUSTON
, TX
, 77098
Practice Phone
: 713-526-2225;
Practice Fax
: 713-590-0054
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