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General NPI Number Information
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NPI Number | 1043556509
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Entity Type | Organization
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Legal Business Name | INDIANA MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 01/02/2013
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 5627 HALLIE RAE LN
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City | TERRE HAUTE
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State | IN
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Zip | 47802-8199
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Country | US
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Telephone | 812-230-5700
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Fax | 812-917-2123
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Provider Business Mailing Address
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Address Line | 5627 HALLIE RAE LN
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City | TERRE HAUTE
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State | IN
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Zip | 47802-8199
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Country | US
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Telephone | 812-230-5700
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Fax | 812-917-2123
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MRS. MAY S BENITO-REFUGIO
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Credential | PT
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Telephone | 812-917-2123
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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 | 05003052A
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License Number State | IN
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