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NPI 1013219906

NPI 1013219906 : JODI L COSEY MPT, CAPS : GRANTVILLE, PA

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General NPI Number Information
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    NPI Number           |    1013219906
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    Entity Type          |    Individual 
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    Provider Name        |    JODI L COSEY MPT, CAPS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/26/2010
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    Last Update Date     |    11/26/2010
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Provider Practice Location Address
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    Address Line         |    7 HILLTOP RD 
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    City                 |    GRANTVILLE
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    State                |    PA
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    Zip                  |    17028-8750
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    Country              |    US
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    Telephone            |    717-461-5613
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7 HILLTOP RD 
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    City                 |    GRANTVILLE
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    State                |    PA
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    Zip                  |    17028-8750
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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       |    PT011415L
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    License Number State |    PA
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