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General NPI Number Information
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NPI Number | 1164186086
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Entity Type | Individual
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Provider Name | PRESTON ALLEN GAMBLE
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Gender | Male
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Dates
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Enumeration Date | 10/27/2021
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 4000 CAMBRIDGE ST
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City | KANSAS CITY
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State | KS
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Zip | 66160-8501
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Country | US
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Telephone | 913-588-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 5801 WOODSON ST APT 102
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City | MISSION
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State | KS
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Zip | 66202-2753
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Country | US
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Telephone | 417-987-7686
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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 | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | 1605304
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License Number State | KS
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