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NPI 1245545870

NPI 1245545870 : KAREN LOUISE ROGERS LMT : KALISPELL, MT

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General NPI Number Information
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    NPI Number           |    1245545870
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    Entity Type          |    Individual 
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    Provider Name        |    KAREN LOUISE ROGERS LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/06/2010
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    Last Update Date     |    08/06/2010
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Provider Practice Location Address
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    Address Line         |    103 PONDEROSA LN 
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    City                 |    KALISPELL
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    State                |    MT
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    Zip                  |    59901-6833
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    Country              |    US
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    Telephone            |    406-270-3847
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 8616 
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    City                 |    KALISPELL
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    State                |    MT
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    Zip                  |    59904-1616
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    Country              |    US
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    Telephone            |    406-270-3847
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    391
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    License Number State |    MT
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