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General NPI Number Information
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NPI Number | 1164373460
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Entity Type | Individual
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Provider Name | WILLIAM WESLEY JENKINS
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Gender | Male
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Dates
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Enumeration Date | 02/04/2026
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 5006 LENA ROAD
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City | BRADENTON
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State | FL
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Zip | 34211
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Country | US
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Telephone | 703-346-2911
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Fax |
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Provider Business Mailing Address
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Address Line | 5962 FIORE DR
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City | BRADENTON
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State | FL
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Zip | 34208-4554
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Country | US
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Telephone | 703-346-2911
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 37654
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License Number State | FL
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