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General NPI Number Information
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NPI Number | 1134534134
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Entity Type | Organization
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Legal Business Name | PRIMUS HEALTH
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 1550 W. 86TH ST.
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-2317
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Country | US
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Telephone | 317-407-8109
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Fax |
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Provider Business Mailing Address
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Address Line | 1550 W. 86TH ST.
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-2317
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Country | US
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Telephone | 317-407-8109
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRANK KLENE
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Credential | DPT
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Telephone | 317-407-8109
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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 | 05010406A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 05010408A
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License Number State | IN
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