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NPI 1255772661

NPI 1255772661 : ROBIN EDDY LMT : HARRISVILLE, RI

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General NPI Number Information
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    NPI Number           |    1255772661
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    Entity Type          |    Individual 
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    Provider Name        |    ROBIN EDDY LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/14/2013
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    Last Update Date     |    07/14/2013
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Provider Practice Location Address
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    Address Line         |    249 ROUND TOP RD 
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    City                 |    HARRISVILLE
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    State                |    RI
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    Zip                  |    02830-1037
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    Country              |    US
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    Telephone            |    401-651-2993
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    Fax                  |    401-568-4208
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Provider Business Mailing Address
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    Address Line         |    249 ROUND TOP RD 
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    City                 |    HARRISVILLE
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    State                |    RI
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    Zip                  |    02830-1037
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    Country              |    US
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    Telephone            |    401-651-2993
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    Fax                  |    401-568-4208
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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       |    MT01293
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    License Number State |    RI
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