Practice Name
Address
Address 2
City
State
Alberta, Canada
AUS Capital Territory, Australia
Alaska
Alabama
Arkansas
American Samoa, US
Arizona
British Columbia, Canada
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guam, US
Hawaii
Iowa
Idaho
Illinois
Indiana
Jervis Bay Territory, Australia
Kansas
Kentucky
Louisiana
Massachusetts
Manitoba, Canada
Maryland
Maine
Marshall Islands, US
Michigan
Minnesota
Missouri
Northern Marianas, US
Mississippi
Montana
New Brunswick, Canada
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
Newfoundland and Labrador, Canada
New Mexico
Nova Scotia, Canada
New South Wales, Australia
Northwest Territories, Canada OR Northern Territory, Australia
Nunavut, Canada
Nevada
New York
Ohio
Oklahoma
Ontario, Canada
Oregon
Pennsylvania
Prince Edward Island, Canada
Puerto Rico, US
Quebec, Canada
Queensland, Australia
Rhode Island
South Australia, Australia
South Carolina
South Dakota
Saskatchewan, Canada
Tasmania, Australia
Tennessee
Texas
Utah
Virginia
Virgin Islands, US
Victoria, Australia
Vermont
Washington OR Western Austrlia, Australia
Wisconsin
West Virginia
Wyoming
Yukon Territory, Canada
Zip
Phone
Ext.
Fax Number
DEA Number
Nat. Provider Identifier
Type of Business
Pediatrics
Family Practice
Adolescent Medicine
Internal Medicine
General Practice
Occupational Health Clinic PHI
Occupational Health Clinic Private