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General NPI Number Information
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NPI Number | 1134717648
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Entity Type | Organization
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Legal Business Name | ANGELO PHYSICAL THERAPY AND WELLNESS
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Dates
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Enumeration Date | 01/10/2021
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Last Update Date | 01/10/2021
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Provider Practice Location Address
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Address Line | 2025 W BEAUREGARD AVE STE B
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City | SAN ANGELO
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State | TX
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Zip | 76901-3884
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Country | US
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Telephone | 325-650-8903
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Fax |
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Provider Business Mailing Address
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Address Line | 3134 OLD EOLA RD
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City | SAN ANGELO
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State | TX
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Zip | 76905-2950
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. SARAH WILDE
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Credential | DPT
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Telephone | 325-650-8903
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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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