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General NPI Number Information
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NPI Number | 1245450170
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Entity Type | Individual
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Provider Name | SUZANNE CRANE GILMAN PT
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 909 SUMNER ST GODDARD REHAB.
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City | STOUGHTON
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State | MA
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Zip | 02072-3396
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Country | US
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Telephone | 781-297-8510
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Fax |
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Provider Business Mailing Address
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Address Line | 41 NORTHWAY ST
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City | HOLLISTON
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State | MA
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Zip | 01746-2037
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Country | US
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Telephone | 508-429-4786
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Fax | 774-233-0009
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2136
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License Number State | MA
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