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General NPI Number Information
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NPI Number | 1003445859
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Entity Type | Organization
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Legal Business Name | BREAKTHROUGH REHAB CENTER LLC
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 04/03/2020
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Provider Practice Location Address
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Address Line | 29116 FIVE MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-3850
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Country | US
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Telephone | 734-666-5795
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Fax | 734-766-5797
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Provider Business Mailing Address
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Address Line | 29116 FIVE MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-3850
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Country | US
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Telephone | 734-666-5795
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Fax | 734-766-5797
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT A SMITH
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Credential |
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Telephone | 248-707-9121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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