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General NPI Number Information
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NPI Number | 1023366275
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Entity Type | Individual
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Provider Name | BRETT MICHAEL REED PTA
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Gender | Male
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Dates
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Enumeration Date | 08/20/2012
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Last Update Date | 08/20/2012
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Provider Practice Location Address
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Address Line | 303 N HURSTBOURNE PKWY SUITE 200
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City | LOUISVILLE
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State | KY
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Zip | 40222-5185
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Country | US
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Telephone | 502-412-5847
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Fax |
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Provider Business Mailing Address
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Address Line | 114 OAKWOOD DR
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City | COLUMBUS GROVE
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State | OH
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Zip | 45830-1012
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Country | US
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Telephone | 419-615-3327
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 08529
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License Number State | OH
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