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General NPI Number Information
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NPI Number | 1023702685
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Entity Type | Individual
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Provider Name | KEVIN NANCE PT
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Gender | Male
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 534 HILLCREST DR
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City | BRANDENBURG
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State | KY
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Zip | 40108-1296
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Country | US
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Telephone | 270-422-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 670 MAGNOLIA DR NE
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City | CORYDON
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State | IN
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Zip | 47112-7786
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Country | US
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Telephone | 502-262-3919
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 05004130
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License Number State | IN
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