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General NPI Number Information
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NPI Number | 1114998523
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Entity Type | Organization
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Legal Business Name | OPTIMUM THERAPY MISSION
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 1022 E GRIFFIN PARKWAY STE 203
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City | MISSION
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State | TX
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Zip | 78572-2402
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Country | US
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Telephone | 956-424-7885
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Fax | 956-424-7811
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Provider Business Mailing Address
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Address Line | PO BOX 720855
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City | MCALLEN
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State | TX
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Zip | 78504-0855
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Country | US
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Telephone | 956-424-7885
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Fax | 956-424-7811
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | JOHN M. SPEIGHTS
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Credential | P.T.
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Telephone | 956-424-7885
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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 | 1087971
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 656260000
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License Number State | TX
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