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General NPI Number Information
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NPI Number | 1184879975
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Entity Type | Organization
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Legal Business Name | PRO HEALTHCARE SERVICING,LLC
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Dates
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Enumeration Date | 11/21/2008
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Last Update Date | 11/21/2008
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Provider Practice Location Address
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Address Line | 10807 MAIN ST STE 700
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City | FAIRFAX
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State | VA
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Zip | 22030-4749
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Country | US
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Telephone | 646-641-4013
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Fax |
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Provider Business Mailing Address
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Address Line | 10807 MAIN ST STE 700
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City | FAIRFAX
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State | VA
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Zip | 22030-4749
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Country | US
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Telephone | 646-641-4013
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Fax |
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Authorized Official
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Title or Position | PT CLINICAL DIRECTOR
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Name | MR. ERWIN CHENG
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Credential | PT
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Telephone | 646-641-4013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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