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General NPI Number Information
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NPI Number | 1184927691
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Entity Type | Organization
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Legal Business Name | REVERE REHABILITATION CENTER
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 12/06/2010
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Provider Practice Location Address
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Address Line | 199 SHIRLEY AVE
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City | REVERE
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State | MA
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Zip | 02151-3258
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Country | US
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Telephone | 781-286-2222
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Fax | 781-286-2212
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Provider Business Mailing Address
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Address Line | 199 SHIRLEY AVE
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City | REVERE
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State | MA
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Zip | 02151-3258
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Country | US
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Telephone | 781-286-2222
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Fax | 781-286-2212
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Authorized Official
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Title or Position | MANAGER
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Name | FRANK NAJAFI
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Credential |
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Telephone | 781-286-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 3094
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License Number State | MA
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