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General NPI Number Information
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NPI Number | 1265062202
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Entity Type | Organization
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Legal Business Name | RESURGENT HEALTH, LLC
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Dates
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Enumeration Date | 01/17/2020
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 2850 SE POWELL VALLEY RD STE 205A
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City | GRESHAM
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State | OR
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Zip | 97080-1489
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Country | US
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Telephone | 503-484-6128
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Fax |
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Provider Business Mailing Address
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Address Line | 13203 SE 172ND AVE STE 166
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-8738
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Country | US
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Telephone | 503-484-6128
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENJAMIN L. HEATH
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Credential | DC
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Telephone | 503-484-6128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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