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NPI 1174041552

NPI 1174041552 : SHARON HODGE BALDWIN LPTA : IRONDALE, AL

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General NPI Number Information
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    NPI Number           |    1174041552
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    Entity Type          |    Individual 
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    Provider Name        |    SHARON HODGE BALDWIN LPTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/06/2017
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    Last Update Date     |    09/06/2017
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Provider Practice Location Address
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    Address Line         |    4941 MONTEVALLO RD 
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    City                 |    IRONDALE
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    State                |    AL
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    Zip                  |    35210-2418
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    Country              |    US
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    Telephone            |    205-516-4970
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    412 CARRIAGE DR 
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    City                 |    BIRMINGHAM
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    State                |    AL
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    Zip                  |    35214-1329
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    Country              |    US
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    Telephone            |    
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    113
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    License Number State |    AL
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