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General NPI Number Information
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NPI Number | 1003806597
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Entity Type | Individual
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Provider Name | ERIC ANTHONY VIAL MS,PT
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 1525 E WINDMILL LN STE 202
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City | LAS VEGAS
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State | NV
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Zip | 89123-1903
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Country | US
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Telephone | 702-202-1280
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Fax | 702-361-8596
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Provider Business Mailing Address
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Address Line | 515 ASH ST
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City | SUSANVILLE
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State | CA
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Zip | 96130-3711
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Country | US
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Telephone | 530-257-7711
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Fax | 530-257-2170
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT14879
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License Number State | CA
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