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General NPI Number Information
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NPI Number | 1144174632
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Entity Type | Individual
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Provider Name | HAYDEN C ROSE PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 02/23/2026
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Last Update Date | 02/23/2026
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Provider Practice Location Address
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Address Line | 401 N CANAL ST
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City | CARLSBAD
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State | NM
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Zip | 88220-5873
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Country | US
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Telephone | 575-885-1814
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Fax |
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Provider Business Mailing Address
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Address Line | 236 BYERS RD
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City | MANSFIELD
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State | AR
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Zip | 72944-9738
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Country | US
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Telephone | 479-207-1771
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PT5634
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License Number State | AR
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