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General NPI Number Information
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NPI Number | 1093600835
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Entity Type | Organization
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Legal Business Name | ENDURO PT PLLC
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 9 MAY LN
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City | BELLA VISTA
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State | AR
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Zip | 72715-4804
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Country | US
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Telephone | 505-917-3911
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Fax | 479-250-0379
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Provider Business Mailing Address
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Address Line | 9 MAY LN
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City | BELLA VISTA
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State | AR
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Zip | 72715-4804
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Country | US
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Telephone | 505-917-3911
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Fax | 479-250-0379
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. ALEX W RUSSELL
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Credential | PT, DPT, CSCS
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Telephone | 505-917-3911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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