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General NPI Number Information
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NPI Number | 1144632787
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Entity Type | Individual
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Provider Name | DAVID WILKINSON LMT, CMT
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Gender | Male
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 317 1ST AVE W SUITE 101
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City | ALBANY
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State | OR
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Zip | 97321-2225
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Country | US
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Telephone | 541-905-4158
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Fax |
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Provider Business Mailing Address
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Address Line | 1422 15TH AVE. S.E. APARTMENT D
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City | ALBANY
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State | OR
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Zip | 97322
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Country | US
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Telephone | 760-567-9107
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 19883
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 9196
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License Number State | CA
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