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General NPI Number Information
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NPI Number | 1154568624
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Entity Type | Individual
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Provider Name | JOHN PAUL MCCLAIN RPT
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Gender | Male
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Dates
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Enumeration Date | 01/20/2009
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Last Update Date | 01/20/2009
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Provider Practice Location Address
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Address Line | 789 SAINT ALBANS DR
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City | BOCA RATON
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State | FL
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Zip | 33486-1522
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Country | US
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Telephone | 954-562-6610
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Fax | 561-393-3708
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Provider Business Mailing Address
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Address Line | 789 SAINT ALBANS DR
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City | BOCA RATON
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State | FL
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Zip | 33486-1522
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Country | US
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Telephone | 954-562-6610
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Fax | 561-393-3708
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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 | 0017902
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License Number State | FL
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