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Showing codes 1255358842 — 1356368955
1255358842 -
THOMAS
J
DONOVAN
MD
Other Name
:
Mailing Address
:
3691 RUTGER AVE
PROVIDER ENROLLMENT
ST LOUIS
MO
63110
Phone
: 314-977-4440;
Fax
: ;
Practice Location Address
:
3660 VISTA
,
, ST LOUIS
, MO
, 63110
Practice Phone
: 314-577-8887;
Practice Fax
: 314-268-5111
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1164449757 -
JOHN
A
STITH
MD
Other Name
:
Mailing Address
:
3691 RUTGER AVE
PROVIDER ENROLLMENT
ST LOUIS
MO
63110
Phone
: 314-977-3828;
Fax
: 314-977-6777;
Practice Location Address
:
3660 VISTA
,
, ST LOUIS
, MO
, 63110
Practice Phone
: 314-577-8887;
Practice Fax
: 314-268-5111
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1073530663 -
DR.
DR.
RANDALL
WALTER
NAMETH
DDS
Other Name
:
Mailing Address
:
716 WORTHINGTON WOODS BLVD
WORTHINGTON
OH
43085-5713
Phone
: 614-846-2222;
Fax
: 614-846-3020;
Practice Location Address
:
716 WORTHINGTON WOODS BLVD
,
, WORTHINGTON
, OH
, 43085-5713
Practice Phone
: 614-846-2222;
Practice Fax
: 614-846-3020
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1982621579 -
MRS.
MRS.
CARLA
E
FORTUNE
AUD
Other Name
:
Mailing Address
:
133 BENMORE DR
SUITE 100
WINTER PARK
FL
32792-4143
Phone
: 407-644-4883;
Fax
: 407-644-3697;
Practice Location Address
:
133 BENMORE DR
, SUITE 100
, WINTER PARK
, FL
, 32792-4143
Practice Phone
: 407-644-4883;
Practice Fax
: 407-644-3697
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1891712493 -
NORTHRIDGE FAMILY PRACTICE LLC
Other Name
:
Mailing Address
:
PO BOX 279
HALE
MI
48739-0279
Phone
: 989-728-6000;
Fax
: 989-728-6003;
Practice Location Address
:
3190 NORTHRIDGE DRIVE
,
, HALE
, MI
, 48739-9276
Practice Phone
: 989-728-6000;
Practice Fax
: 989-728-6003
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1700803301 -
BARBARA
SOCHA
MD
Other Name
:
Mailing Address
:
91550 OVERSEAS HWY STE 215
TAVERNIER
FL
33070-2513
Phone
: 305-853-9236;
Fax
: 305-853-9238;
Practice Location Address
:
91550 OVERSEAS HWY STE 215
,
, TAVERNIER
, FL
, 33070-2513
Practice Phone
: 305-853-9236;
Practice Fax
: 305-853-9238
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1619994217 -
MR.
MR.
STEPHEN
R
BEAUPRE
MD
Other Name
:
Mailing Address
:
1312 OAKLAWN AVE
MIDLAND MEDICAL
CRANSTON
RI
02920
Phone
: 401-463-3380;
Fax
: 401-463-3308;
Practice Location Address
:
1312 OAKLAWN AVE
, MIDLAND MEDICAL
, CRANSTON
, RI
, 02920
Practice Phone
: 401-463-3380;
Practice Fax
: 401-463-3308
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1528085123 -
MICHAEL
CHIH-MAI
YEN
MD FACP
Other Name
:
Mailing Address
:
821 N EUTAW ST
SUITE 401
BALTIMORE
MD
21201
Phone
: 410-383-3464;
Fax
: 410-383-3468;
Practice Location Address
:
827 LINDEN AVE
,
, BALTIMORE
, MD
, 21201
Practice Phone
: 410-225-8947;
Practice Fax
:
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1437176039 -
UNIVERSITY MEDICAL ASSOCIATES
Other Name
:
MUSC PHYSICIANS
Mailing Address
:
PO BOX 751461
CHARLOTTE
NC
28275-1461
Phone
: 843-792-6200;
Fax
: ;
Practice Location Address
:
1200 JOHNNIE DODDS BLVD
,
, MT PLEASANT
, SC
, 29464-3231
Practice Phone
: 843-792-1414;
Practice Fax
:
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1346267945 -
MT PLEASANT OPHTHALMOLOGY
Other Name
:
Mailing Address
:
1705 BEAUCASTEL RD
MT PLEASANT
SC
29464-3657
Phone
: 843-884-2015;
Fax
: 843-881-7068;
Practice Location Address
:
1705 BEAUCASTEL RD
,
, MT PLEASANT
, SC
, 29464-3657
Practice Phone
: 843-884-2015;
Practice Fax
: 843-881-7068
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1255358859 -
DR.
DR.
ROBERT
J.
MARTINEZ
D.C.
Other Name
:
Mailing Address
:
20911 LAKE TALIA BLVD
LAND O LAKES
FL
34638-3703
Phone
: 813-929-0815;
Fax
: ;
Practice Location Address
:
3460 MARINER BLVD
,
, SPRING HILL
, FL
, 34609-2462
Practice Phone
: 352-686-1686;
Practice Fax
:
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1164449765 -
MS.
MS.
LISA
M
HOFFMAN
FNP-C
Other Name
:
LISA
M
VIGNEAU
Mailing Address
:
2325 SUMMIT PARK DR
SUITE 3
PETOSKEY
MI
49770-8774
Phone
: 231-439-5100;
Fax
: 231-439-9292;
Practice Location Address
:
2325 SUMMIT PARK DR
, SUITE 3
, PETOSKEY
, MI
, 49770-8774
Practice Phone
: 231-439-5100;
Practice Fax
: 231-439-9292
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1073530671 -
DR.
DR.
SUSAN
M
YEAGER
DPM
Other Name
:
Mailing Address
:
1901 COOK ST
DYERSBURG
TN
38024-1882
Phone
: 731-885-0220;
Fax
: ;
Practice Location Address
:
429 REDCLIFF DR STE 100
,
, REDDING
, CA
, 96002-0167
Practice Phone
: 731-286-2139;
Practice Fax
:
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1982621587 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1790702397 -
CHRISTINA
M.
MYINT
M.D.
Other Name
:
Mailing Address
:
P.O. BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8450;
Fax
: ;
Practice Location Address
:
7515 GREENVILLE AVE STE 503
,
, DALLAS
, TX
, 75231-3865
Practice Phone
: 214-239-1938;
Practice Fax
: 214-239-1939
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1609893205 -
LISA
M
HOLLIER
M.D.
Other Name
:
Mailing Address
:
PO BOX 201088
HOUSTON
TX
77216-1088
Phone
: 713-500-3500;
Fax
: ;
Practice Location Address
:
6410 FANNIN ST
, 720
, HOUSTON
, TX
, 77030-3000
Practice Phone
: 832-325-7200;
Practice Fax
: 713-512-2237
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1518984111 -
BROCK
LYNDSEY
ROBINSON
MD
Other Name
:
Mailing Address
:
3021 VOYAGER DR
GREEN BAY
WI
54311-8303
Phone
: 920-496-4700;
Fax
: 920-272-1621;
Practice Location Address
:
3021 VOYAGER DR
,
, GREEN BAY
, WI
, 54311-8303
Practice Phone
: 920-496-4700;
Practice Fax
: 920-272-1621
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1427075027 -
FLETCHER HOSPITAL INC.
Other Name
:
PARK RIDGE HEALTH, PARK RIDGE HOSPITAL
Mailing Address
:
PO BOX 948117
ATLANTA
GA
30394-8117
Phone
: 828-687-5616;
Fax
: 828-687-8076;
Practice Location Address
:
100 HOSPITAL DR
,
, HENDERSONVILLE
, NC
, 28792-5272
Practice Phone
: 828-684-8501;
Practice Fax
: 828-687-5298
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1336166933 -
DAVID
B
MCREYNOLDS
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-702-1605;
Practice Location Address
:
1500 S MAIN ST
, SUITE 303
, FORT WORTH
, TX
, 76104-4917
Practice Phone
: 817-702-1172;
Practice Fax
: 817-702-1605
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1245257849 -
DR.
DR.
GREGORY
E
BUZZELL
DC
Other Name
:
Mailing Address
:
139 HAVEN AVE AT 173RD ST
NEW YORK
NY
10032
Phone
: 212-740-1270;
Fax
: 212-740-2144;
Practice Location Address
:
139 HAVEN AVE AT 173RD ST
,
, NEW YORK
, NY
, 10032
Practice Phone
: 212-740-1270;
Practice Fax
: 212-740-2144
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1154348753 -
DAVID
C
KELLY
PA
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-332-6015;
Practice Location Address
:
BEN HOGAN CENTER
, 800 5TH AVE., SUITE 410
, FORT WORTH
, TX
, 76104
Practice Phone
: 817-332-6092;
Practice Fax
: 817-332-6015
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1063439669 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1972520575 -
JAMES
P
HERD
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-923-0087;
Practice Location Address
:
1250 8TH AVENUE
, SUITE 430
, FORT WORTH
, TX
, 76104-4144
Practice Phone
: 817-923-0023;
Practice Fax
: 817-923-0087
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1881611481 -
JOHN
A
RICHARDS
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-336-6416;
Practice Location Address
:
556 8TH AVE
,
, FORT WORTH
, TX
, 76104-2004
Practice Phone
: 817-336-6222;
Practice Fax
: 817-336-6416
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1699792291 -
TRACY
RUKAB
MUNFORD
MD
Other Name
:
TRACY
MARIE
RUKAB
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-433-5441;
Practice Location Address
:
6100 HARRIS PARKWAY
, SUITE 320
, FORT WORTH
, TX
, 76132-4133
Practice Phone
: 817-433-5499;
Practice Fax
: 817-433-5441
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1508883109 -
DAVID
THOMPSON
M.D., FACEP
Other Name
:
Mailing Address
:
75 REMIT DRIVE
LOCKBOX 1209
CHICAGO
IL
60675-1209
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
3249 OAK PARK AVE
,
, BERWYN
, IL
, 60402-3429
Practice Phone
: 708-783-9100;
Practice Fax
:
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1417974015 -
STEVE
YU LIANG
SHEN
MD FACP
Other Name
:
Mailing Address
:
821 N EUTAW ST
SUITE 401
BALTIMORE
MD
21201
Phone
: 410-383-3464;
Fax
: 410-383-3468;
Practice Location Address
:
827 LINDEN AVE
,
, BALTIMORE
, MD
, 21201
Practice Phone
: 410-225-8947;
Practice Fax
:
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1326065921 -
DR.
DR.
YVONNE
EVA
BRACAMONTES
MD
Other Name
:
Mailing Address
:
801 E NOLANA AVE
SUITE 4
MCALLEN
TX
78504-6104
Phone
: 956-686-2626;
Fax
: 956-686-1616;
Practice Location Address
:
801 E NOLANA AVE
, SUITE 4
, MCALLEN
, TX
, 78504-6104
Practice Phone
: 956-686-2626;
Practice Fax
: 956-686-1616
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1235156837 -
TARA
M
VIECHNICKI
MD
Other Name
:
Mailing Address
:
477 N EL CAMINO REAL
STE C202
ENCINITAS
CA
92024-1332
Phone
: 760-631-3500;
Fax
: ;
Practice Location Address
:
477 N EL CAMINO REAL STE C202
,
, ENCINITAS
, CA
, 92024-1332
Practice Phone
: 760-631-3500;
Practice Fax
:
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1144247743 -
RITA
YANEZ
HORTON
M.D.
Other Name
:
Mailing Address
:
1501 KINGS HWY
DEPARTMENT OF PSYCHIATRY
SHREVEPORT
LA
71103-4228
Phone
: 318-813-2445;
Fax
: 318-813-2447;
Practice Location Address
:
1501 KINGS HWY
, DEPARTMENT OF PSYCHIATRY
, SHREVEPORT
, LA
, 71103-4228
Practice Phone
: 318-813-2445;
Practice Fax
: 318-813-2447
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1053338657 -
BRUCE
R
DZIURA
MD
Other Name
:
Mailing Address
:
PO BOX 789
LUDLOW
MA
01056-0789
Phone
: 413-509-1000;
Fax
: 413-509-1003;
Practice Location Address
:
299 CAREW ST
,
, SPRINGFIELD
, MA
, 01104-2301
Practice Phone
: 413-748-9513;
Practice Fax
: 413-748-6844
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1962429563 -
DR.
DR.
JAMES
D
KERNER
M.D., PHD
Other Name
:
Mailing Address
:
7300 RANCH ROAD 2222, BLDG 1, STE 200
AUSTIN
TX
78730-3255
Phone
: 512-759-8932;
Fax
: 512-233-2711;
Practice Location Address
:
141 N ROADRUNNER PKWY STE 228
,
, LAS CRUCES
, NM
, 88011-2001
Practice Phone
: 575-521-1177;
Practice Fax
: 575-449-4963
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1871510479 -
DR.
DR.
LOURDES
MAGALI
IRIZARRY
MD
Other Name
:
Mailing Address
:
113 HOLLAND AVE
ALBANY
NY
12208-3410
Phone
: 518-626-6730;
Fax
: 518-626-6735;
Practice Location Address
:
113 HOLLAND AVE
,
, ALBANY
, NY
, 12208-3410
Practice Phone
: 518-626-6730;
Practice Fax
: 518-626-6735
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1780601385 -
KAREN
R
THOMPSON
CRNP
Other Name
:
Mailing Address
:
PO BOX 858
MC A410
HERSHEY
PA
17033-0858
Phone
: 800-243-1455;
Fax
: ;
Practice Location Address
:
500 UNIVERSITY DR
,
, HERSHEY
, PA
, 17033-2360
Practice Phone
: 800-243-1455;
Practice Fax
:
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1598782195 -
MRS.
MRS.
PATRICIA
MARIE
BOWLES-LYONS
LCSW, LP
Other Name
:
Mailing Address
:
191 JORALEMON ST
14TH FLOOR
BROOKLYN
NY
11201-4306
Phone
: 718-722-6146;
Fax
: 718-722-6217;
Practice Location Address
:
191 JORALEMON ST
, 14TH FLOOR
, BROOKLYN
, NY
, 11201-4306
Practice Phone
: 718-722-6146;
Practice Fax
: 718-722-6217
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1407873003 -
PROFESSIONAL PHYSICAL THERAPY, P.C.
Other Name
:
Mailing Address
:
3162 N VERMILION ST
DANVILLE
IL
61832-1166
Phone
: 217-446-7878;
Fax
: ;
Practice Location Address
:
3162 N VERMILION ST
,
, DANVILLE
, IL
, 61832-1166
Practice Phone
: 217-446-7878;
Practice Fax
:
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1316964919 -
MICHELLE
TORRES
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-348-9579;
Practice Location Address
:
1209 COLLEGE AVE.
,
, FORT WORTH
, TX
, 76104-4516
Practice Phone
: 817-348-9569;
Practice Fax
: 817-348-9579
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1225055825 -
DORRIS
A
MORRISSETTE
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-433-5582;
Practice Location Address
:
6100 HARRIS PKWY
, STE 350
, FORT WORTH
, TX
, 76132-4101
Practice Phone
: 817-433-5495;
Practice Fax
: 817-433-5582
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1134146731 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1043237647 -
HARRY
ROSENTHAL
JR.
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-423-3943;
Practice Location Address
:
4932 OVERTON RIDGE BLVD
,
, FORT WORTH
, TX
, 76132-1909
Practice Phone
: 817-423-3937;
Practice Fax
: 817-423-3943
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1952328551 -
JOHN
G
BRISCOE
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-433-5100;
Practice Location Address
:
6100 HARRIS PARKWAY
, SUITE 355
, FORT WORTH
, TX
, 76132-4134
Practice Phone
: 817-433-5488;
Practice Fax
: 817-433-5125
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1861419467 -
CYNTHIA
STEPHENSON
D.O.
Other Name
:
Mailing Address
:
PO BOX 1347
DUBLIN
GA
31040-1347
Phone
: 404-218-5074;
Fax
: ;
Practice Location Address
:
511 BELLEVUE AVE
, BOX 1347
, DUBLIN
, GA
, 31021-5331
Practice Phone
: 404-218-5074;
Practice Fax
:
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1770500373 -
ETHAN
STERK
D.O.
Other Name
:
Mailing Address
:
840 S WOOD ST
RM 440 CSN, MC718
CHICAGO
IL
60612-7323
Phone
: ;
Fax
: ;
Practice Location Address
:
2525 S MICHIGAN AVE
,
, CHICAGO
, IL
, 60616-2333
Practice Phone
: 312-567-2000;
Practice Fax
:
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1689691289 -
PRISCILLA
STITH
P.A.-C, MS
Other Name
:
Mailing Address
:
8 DAX CT
BRIDGETON
MO
63044-3522
Phone
: 314-770-2904;
Fax
: ;
Practice Location Address
:
4500 MEMORIAL DR
,
, BELLEVILLE
, IL
, 62226-5360
Practice Phone
: 618-257-4088;
Practice Fax
:
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1497772099 -
DI
SU
M.D.
Other Name
:
Mailing Address
:
2222 MARONEAL ST UNIT 444
HOUSTON
TX
77030-3258
Phone
: ;
Fax
: ;
Practice Location Address
:
9774 KATY FWY STE 500
,
, HOUSTON
, TX
, 77055-6240
Practice Phone
: 832-358-0200;
Practice Fax
:
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1306863907 -
SARAH
SVOBODA
M.D.
Other Name
:
Mailing Address
:
PO BOX 17571
BALTIMORE
MD
21297-1571
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
1635 NORTH LOOP W
,
, HOUSTON
, TX
, 77008-1532
Practice Phone
: 713-867-2000;
Practice Fax
:
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1215954813 -
MOHAMMAD
TABATABAEI
P.A.-C
Other Name
:
Mailing Address
:
2300 N EDWARD ST
GSBLL
DECATUR
IL
62526-4163
Phone
: 217-876-2857;
Fax
: 217-876-2874;
Practice Location Address
:
1220 W JACKSON ST
,
, SULLIVAN
, IL
, 61951-1032
Practice Phone
: 217-728-2042;
Practice Fax
: 217-728-2485
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1124045729 -
ROBERT
TARR
M.D.
Other Name
:
Mailing Address
:
75 REMITT DRIVE
LOCKBOX 6810
CHICAGO
IL
60675-6810
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
11133 DUNN RD
,
, SAINT LOUIS
, MO
, 63136-6119
Practice Phone
: 217-544-6464;
Practice Fax
:
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1033136635 -
ALLEN
THOMAS
P.A.-C
Other Name
:
Mailing Address
:
101 W UNIVERSITY AVE
CHAMPAIGN
IL
61820-3909
Phone
: 217-366-8107;
Fax
: 217-366-6106;
Practice Location Address
:
1801 WINDSOR RD
,
, CHAMPAIGN
, IL
, 61822-6217
Practice Phone
: 217-366-8130;
Practice Fax
: 217-366-6106
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1851318455 -
UNIVERSITY MEDICAL ASSOCIATES
Other Name
:
MUSC PHYSICIANS
Mailing Address
:
PO BOX 751461
CHARLOTTE
NC
28275-1461
Phone
: 843-792-6200;
Fax
: ;
Practice Location Address
:
171 ASHLEY AVE
,
, CHARLESTON
, SC
, 29425-8908
Practice Phone
: 843-792-1414;
Practice Fax
:
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1760409361 -
MARY
RAGSDALE
NP
Other Name
:
Mailing Address
:
1021 BANDANA BLVD E
SUITE 200
SAINT PAUL
MN
55108-5113
Phone
: 651-642-2700;
Fax
: 651-642-9441;
Practice Location Address
:
7920 OLD CEDAR AVE S
,
, BLOOMINGTON
, MN
, 55425-1207
Practice Phone
: 952-851-1000;
Practice Fax
: 952-851-1092
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1679590277 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1588681183 -
DAVID
M
RUTLEDGE
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-263-3702;
Practice Location Address
:
7201 HAWKINS VIEW DR STE 151
,
, FORT WORTH
, TX
, 76132-3934
Practice Phone
: 817-263-7200;
Practice Fax
: 817-377-6558
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1396762993 -
MR.
MR.
BRIAN
ALAN
JONES
LCSW
Other Name
:
Mailing Address
:
PO BOX 1108
TEMPLE
TX
76503-1108
Phone
: 254-773-4022;
Fax
: 254-773-0919;
Practice Location Address
:
3010 SCOTT BLVD
, SUITE #103
, TEMPLE
, TX
, 76504
Practice Phone
: 254-773-4022;
Practice Fax
: 254-773-0919
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1205853801 -
MS.
MS.
SUE
ANNE
HUBER
MSW LCSW
Other Name
:
Mailing Address
:
PO BOX 22040
GREEN BAY
WI
54305-2040
Phone
: 920-445-7222;
Fax
: 920-445-7289;
Practice Location Address
:
1800 LAWRENCE DR
,
, DE PERE
, WI
, 54115-9108
Practice Phone
: 920-336-1229;
Practice Fax
: 920-983-3226
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1114944717 -
JAMES
F
PARKER
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-433-5171;
Practice Location Address
:
6100 HARRIS PARKWAY
, SUITE 355
, FORT WORTH
, TX
, 76132-4134
Practice Phone
: 817-433-5488;
Practice Fax
: 817-433-5171
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1023035623 -
EDUARDO
D
CASTILLO
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-924-9960;
Practice Location Address
:
2000 COOPER ST STE 100B
,
, FORT WORTH
, TX
, 76104-2528
Practice Phone
: 817-924-9002;
Practice Fax
: 817-924-9960
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1932126539 -
DR.
DR.
CHRISTINE
ANN
MASON
PHD
Other Name
:
CHRIS
MASON
Mailing Address
:
3393 IRIS AVENUE
SUITE 106
BOULDER
CO
80301-1956
Phone
: 303-886-6307;
Fax
: 303-449-6825;
Practice Location Address
:
3393 IRIS AVENUE
, SUITE 106
, BOULDER
, CO
, 80301-1956
Practice Phone
: 303-886-6307;
Practice Fax
: 303-449-6825
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1841217445 -
JEFF
STANLEY
M.D., FACP, FACEP
Other Name
:
Mailing Address
:
217 ARCHERS MEAD
WILLIAMSBURG
VA
23185-6526
Phone
: 757-253-1727;
Fax
: ;
Practice Location Address
:
500 J CLYDE MORRIS BLVD
,
, NEWPORT NEWS
, VA
, 23601-1929
Practice Phone
: 757-594-2000;
Practice Fax
:
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1750308359 -
BRANDON
T.
THOMAS
D.O.
Other Name
:
Mailing Address
:
550 GAGE BLVD STE 101
RICHLAND
WA
99352-9532
Phone
: 509-942-3627;
Fax
: 509-627-2983;
Practice Location Address
:
4804 W CLEARWATER AVE
,
, KENNEWICK
, WA
, 99336-2119
Practice Phone
: 509-942-2355;
Practice Fax
: 509-222-1289
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1669499265 -
DAVID
THOMAS
M.D.
Other Name
:
Mailing Address
:
PO BOX 703
TRAVERSE CITY
MI
49685-0703
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
801 S MILWAUKEE AVE
,
, LIBERTYVILLE
, IL
, 60048-3204
Practice Phone
: 847-362-2900;
Practice Fax
:
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1578580171 -
JEFFREY
THOMPSON
M.D.
Other Name
:
Mailing Address
:
PO BOX 849894
DALLAS
TX
75284-0001
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
2606 HOSPITAL BLVD
,
, CORPUS CHRISTI
, TX
, 78405-1804
Practice Phone
: 361-881-3000;
Practice Fax
:
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1487671087 -
TIMOTHY
DAVID
TONINI
DO
Other Name
:
Mailing Address
:
1111 EMERALD BAY RD
SOUTH LAKE TAHOE
CA
96150-6207
Phone
: 530-543-5659;
Fax
: 530-541-8723;
Practice Location Address
:
2170 SOUTH AVE
,
, SOUTH LAKE TAHOE
, CA
, 96150-7026
Practice Phone
: 530-541-3420;
Practice Fax
:
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1295752897 -
CHUONG
TRAN
M.D.
Other Name
:
Mailing Address
:
250 HOSPITAL PKWY
SAN JOSE
CA
95119-1103
Phone
: 408-972-7000;
Fax
: ;
Practice Location Address
:
250 HOSPITAL PKWY
,
, SAN JOSE
, CA
, 95119-1103
Practice Phone
: 408-972-7000;
Practice Fax
:
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1104843705 -
THOMAS
TRAN
M.D.
Other Name
:
Mailing Address
:
2203 W ENNIS AVE
SUITE 300
ENNIS
TX
75119-8050
Phone
: 972-875-2858;
Fax
: 972-875-2928;
Practice Location Address
:
2203 W ENNIS AVE
, SUITE 300
, ENNIS
, TX
, 75119-8050
Practice Phone
: 972-875-2858;
Practice Fax
: 972-875-2928
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1013934611 -
DR.
DR.
ERIC
TUCHSCHERER
M.D.
Other Name
:
Mailing Address
:
1907 W SYCAMORE ST
KOKOMO
IN
46901-5148
Phone
: ;
Fax
: ;
Practice Location Address
:
1907 W SYCAMORE ST
,
, KOKOMO
, IN
, 46901-5148
Practice Phone
: 765-456-5433;
Practice Fax
:
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1922025527 -
LANNY
TURNER
M.D.
Other Name
:
Mailing Address
:
110 S VISITING EAGLE ST
SANTEE HEALTH CLINIC
NIOBRARA
NE
68760-7201
Phone
: 402-857-2300;
Fax
: ;
Practice Location Address
:
110 S VISITING EAGLE ST
, SANTEE HEALTH CLINIC
, NIOBRARA
, NE
, 68760-7201
Practice Phone
: 402-857-2300;
Practice Fax
:
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1831116433 -
CALVIN
P
WADLEY
M.D., FACEP
Other Name
:
Mailing Address
:
109 N OAK PARK AVE APT 2
OAK PARK
IL
60301-1362
Phone
: 708-524-8904;
Fax
: 708-524-8907;
Practice Location Address
:
109 N OAK PARK AVE APT 2
,
, OAK PARK
, IL
, 60301-1362
Practice Phone
: 708-524-8904;
Practice Fax
: 708-524-8907
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1740207349 -
DR.
DR.
GENE
EDWARD
WALKER
JR.
M.D.
Other Name
:
Mailing Address
:
113 HYPOINT ST
GADSDEN
AL
35901-5423
Phone
: 806-236-8738;
Fax
: ;
Practice Location Address
:
1201 7TH ST SE
,
, DECATUR
, AL
, 35601-3337
Practice Phone
: 256-973-2000;
Practice Fax
:
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1659398253 -
CORINNA
WARREN
M.D.
Other Name
:
Mailing Address
:
224 S WOODS MILL RD STE 510S
CHESTERFIELD
MO
63017-3611
Phone
: 314-205-6605;
Fax
: 314-590-5928;
Practice Location Address
:
224 S WOODS MILL RD
, STE 620
, CHESTERFIELD
, MO
, 63017-3451
Practice Phone
: 314-205-6605;
Practice Fax
: 314-590-5928
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1568489169 -
JAOU-CHEN
HUANG
M.D.
Other Name
:
Mailing Address
:
PO BOX 5865
LUBBOCK
TX
79408-5865
Phone
: 806-743-2898;
Fax
: 806-743-2787;
Practice Location Address
:
3601 4TH ST
,
, LUBBOCK
, TX
, 79430-9410
Practice Phone
: 806-743-3150;
Practice Fax
: 806-743-3168
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1477570075 -
DR.
DR.
WAYNE
K
GERSOFF
M.D.
Other Name
:
Mailing Address
:
8101 E LOWRY BLVD
SUITE 230
DENVER
CO
80230-7196
Phone
: 303-344-9090;
Fax
: 303-344-1912;
Practice Location Address
:
8101 E LOWRY BLVD
, SUITE 230
, DENVER
, CO
, 80230-7196
Practice Phone
: 303-344-9090;
Practice Fax
: 303-344-1912
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1386661981 -
MRS.
MRS.
STARRLA
K
RODRIGUEZ
PT
Other Name
:
STARRLA
K
SIMMONS
Mailing Address
:
PO BOX 8150
CORPUS CHRISTI
TX
78468-8150
Phone
: 361-723-0079;
Fax
: 361-814-7009;
Practice Location Address
:
4918 HOLLY STE. B
,
, CORPUS CHRISTI
, TX
, 78411
Practice Phone
: 361-723-0079;
Practice Fax
: 361-814-7009
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1194742791 -
JESSE
E
SMITH
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-920-0068;
Practice Location Address
:
923 PENNSYLVANIA AVENUE
, SUITE 100
, FORT WORTH
, TX
, 76104-2254
Practice Phone
: 817-920-0484;
Practice Fax
: 817-920-0068
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1003833609 -
DR.
DR.
DAVID
A
BASS
PT, DPT
Other Name
:
Mailing Address
:
1565 OAKBRIDGE DR STE C
POWHATAN
VA
23139-8070
Phone
: 804-372-8000;
Fax
: 888-972-4875;
Practice Location Address
:
1565 OAKBRIDGE DR STE C
,
, POWHATAN
, VA
, 23139-8070
Practice Phone
: 804-372-8000;
Practice Fax
: 888-972-4875
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1912924515 -
MARK
H
BERNHARD
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-378-3699;
Practice Location Address
:
5612 EDWARDS RANCH RD
,
, FORT WORTH
, TX
, 76109-4145
Practice Phone
: 817-263-7200;
Practice Fax
: 817-263-7206
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1821015421 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1730106337 -
RICHARD
D
SCHUSTER
MD
Other Name
:
Mailing Address
:
PO BOX 733784
DALLAS
TX
75373-3784
Phone
: 682-885-1855;
Fax
: 682-885-1396;
Practice Location Address
:
1500 COOPER ST
,
, FORT WORTH
, TX
, 76104-2710
Practice Phone
: 682-885-4405;
Practice Fax
: 682-885-4407
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1649297243 -
ROBERT
K
WATSON
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-921-2701;
Practice Location Address
:
1250 8TH AVENUE
, SUITE 440
, FORT WORTH
, TX
, 76104-4144
Practice Phone
: 817-923-5558;
Practice Fax
: 817-921-2701
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1558388157 -
DR.
DR.
MICHAEL
J.
SPENCE
MD
Other Name
:
Mailing Address
:
1650 45TH AVE
SUITE 2C
MUNSTER
IN
46321-3962
Phone
: 219-513-2267;
Fax
: 219-836-1276;
Practice Location Address
:
1650 45TH AVE
, SUITE 2C
, MUNSTER
, IN
, 46321-3962
Practice Phone
: 219-513-2267;
Practice Fax
: 219-836-1276
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1467479063 -
HEATHER
SIMMONS
MSN, FNP, APRN
Other Name
:
Mailing Address
:
1478 JORDAN HILLS CT
CLEARWATER
FL
33756-2368
Phone
: 727-461-3896;
Fax
: 727-443-4085;
Practice Location Address
:
1478 JORDAN HILLS CT
,
, CLEARWATER
, FL
, 33756-2368
Practice Phone
: 727-461-3896;
Practice Fax
: 727-443-4085
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1376560979 -
MICHAEL
R
SIMMONS
M.D.
Other Name
:
Mailing Address
:
PO BOX 849897
DALLAS
TX
75284-0001
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
600 ELIZABETH ST
,
, CORPUS CHRISTI
, TX
, 78404-2235
Practice Phone
: 361-902-4000;
Practice Fax
:
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1285651885 -
ANANT
SINGH
M.D.
Other Name
:
Mailing Address
:
PO BOX 17572
BALTIMORE
MD
21297-1572
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
411 W RANDOLPH RD
,
, HOPEWELL
, VA
, 23860-2938
Practice Phone
: 804-330-2000;
Practice Fax
:
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1093732695 -
JULIE
SLICK
M.D.
Other Name
:
Mailing Address
:
6758 COLBERT ST
NEW ORLEANS
LA
70124-2241
Phone
: 504-342-2240;
Fax
: ;
Practice Location Address
:
2500 BELLE CHASSE HWY
,
, TERRYTOWN
, LA
, 70056-7127
Practice Phone
: 504-391-5454;
Practice Fax
:
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1902823503 -
ROBERT
SLIWA
D.O.
Other Name
:
Mailing Address
:
75 REMITT DRIVE
LOCKBOX 1374
CHICAGO
IL
60675-1374
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
800 E CARPENTER ST
,
, SPRINGFIELD
, IL
, 62769-0002
Practice Phone
: 217-544-6464;
Practice Fax
:
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1811914419 -
Other Name
:
Mailing Address
:
Phone
: ;
Fax
: ;
Practice Location Address
:
,
,
,
,
Practice Phone
: ;
Practice Fax
:
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1720005325 -
DR.
DR.
RAY
C
SMITH
III
M.D.
Other Name
:
Mailing Address
:
250 N SHADELAND AVE
SUITE 130 - PROVIDER ENROLLMENT
INDIANAPOLIS
IN
46219-4959
Phone
: 317-547-5345;
Fax
: 317-962-4343;
Practice Location Address
:
1606 N 7TH ST
,
, TERRE HAUTE
, IN
, 47804-2706
Practice Phone
: 812-442-2500;
Practice Fax
:
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1639196231 -
TABATHIA
A
SMITH
M.D.
Other Name
:
Mailing Address
:
38935 ANN ARBOR RD
CREDENTIALING DEPT
LIVONIA
MI
48150-3397
Phone
: 888-861-8740;
Fax
: 866-250-6385;
Practice Location Address
:
1500 N 28TH ST
, EMERGENCY DEPT.
, RICHMOND
, VA
, 23223-5332
Practice Phone
: 804-225-1780;
Practice Fax
: 804-225-1705
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1548287147 -
LAURA
SNYDER
P.A.-C
Other Name
:
Mailing Address
:
PO BOX 2147
FORT MYERS
FL
33902-2147
Phone
: 239-343-9800;
Fax
: 239-343-9848;
Practice Location Address
:
4771 S CLEVELAND AVE
,
, FORT MYERS
, FL
, 33907-1317
Practice Phone
: 239-343-9800;
Practice Fax
: 239-343-9848
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1457378051 -
JEANNINE
WALLACE
P.A.-C
Other Name
:
Mailing Address
:
929 GESSNER RD STE 2450
HOUSTON
TX
77024-2593
Phone
: 713-464-9939;
Fax
: ;
Practice Location Address
:
929 GESSNER RD STE 2450
,
, HOUSTON
, TX
, 77024-2593
Practice Phone
: 713-464-9939;
Practice Fax
:
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1366469967 -
HEATHER
WEBB
M.D.
Other Name
:
Mailing Address
:
75 REMIT DRIVE
LOCKBOX 1940
CHICAGO
IL
60675-1940
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
10 HOSPITAL DR
,
, SAINT PETERS
, MO
, 63376-1659
Practice Phone
: 636-916-9000;
Practice Fax
:
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1275550873 -
JOSEPH
WEBER
M.D.
Other Name
:
Mailing Address
:
75 REMIT DR
LOCKBOX 6322
CHICAGO
IL
60675-6322
Phone
: 866-916-5259;
Fax
: 231-922-4030;
Practice Location Address
:
3 ERIE CT
,
, OAK PARK
, IL
, 60302-2519
Practice Phone
: 708-383-6200;
Practice Fax
:
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1184641789 -
DR.
DR.
JAMES
JOSEPH
LYNN
D.M.D.
Other Name
:
Mailing Address
:
PO BOX 1054
EASLEY
SC
29641
Phone
: 864-269-0600;
Fax
: 864-269-0619;
Practice Location Address
:
105 SHERINGHAM DRIVE
,
, EASLEY
, SC
, 29642-3334
Practice Phone
: 864-269-0600;
Practice Fax
: 864-269-0619
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1992722599 -
PASUI FAMILY DENTISTRY
Other Name
:
Mailing Address
:
PO BOX 1489
EASLEY
SC
29641
Phone
: 864-269-5290;
Fax
: 864-220-0409;
Practice Location Address
:
105 SHERINGHAM DRIVE
,
, EASLEY
, SC
, 29642-3334
Practice Phone
: 864-269-5290;
Practice Fax
: 864-220-0409
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1801813407 -
PAMELA
DAWN
RANDOLPH JACKSON
MD
Other Name
:
Mailing Address
:
12605 WILLOW MARSH LANE
BOWIE
MD
20720
Phone
: 301-262-1528;
Fax
: 804-355-6031;
Practice Location Address
:
110 IRVING ST NW
,
, WASHINGTON
, DC
, 20010
Practice Phone
: 800-353-0788;
Practice Fax
: 804-355-6031
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1710904313 -
MOBILE MED INC
Other Name
:
BREATHE MEDICAL
Mailing Address
:
200 WEST 5TH STREET NORTH
SUMMERVILLE
SC
29483
Phone
: 843-285-7903;
Fax
: ;
Practice Location Address
:
114 S CLIFTON AVE
,
, LOUISVILLE
, KY
, 40206-2406
Practice Phone
: 502-896-8335;
Practice Fax
:
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1629095229 -
JAMES
J
BOX
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-433-5110;
Practice Location Address
:
6100 HARRIS PARKWAY
, SUITE 320
, FORT WORTH
, TX
, 76132-4133
Practice Phone
: 817-433-5499;
Practice Fax
: 817-433-5110
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1538186135 -
DAVID
L
STROMAN
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-927-4323;
Practice Location Address
:
1250 8TH AVE., SUITE 240
,
, FORT WORTH
, TX
, 76104-4124
Practice Phone
: 817-927-0456;
Practice Fax
: 817-927-4323
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1447277041 -
MS.
MS.
DEBORAH
LYNNE
EDWARDS
RD, LD
Other Name
:
Mailing Address
:
702 PARK ST
DECORAH
IA
52101-2034
Phone
: 563-382-4676;
Fax
: ;
Practice Location Address
:
909 W 1ST ST
, COMMUNITY MEMORIAL HOSPITAL
, SUMNER
, IA
, 50674-1203
Practice Phone
: 563-578-3275;
Practice Fax
: 563-578-3279
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1356368955 -
BRITTON
R
WEST
MD
Other Name
:
Mailing Address
:
PO BOX 961205
FORT WORTH
TX
76161-1205
Phone
: 817-740-8400;
Fax
: 817-924-9960;
Practice Location Address
:
1420 8TH AVENUE
, SUITE 103
, FORT WORTH
, TX
, 76104-4138
Practice Phone
: 817-924-9002;
Practice Fax
: 817-924-9960
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