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NPI 1265844526

NPI 1265844526 : PRECIOUS BARNES ATC, MS, ART : MC LEAN, VA

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General NPI Number Information
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    NPI Number           |    1265844526
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    Entity Type          |    Individual 
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    Provider Name        |    PRECIOUS BARNES ATC, MS, ART
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/21/2014
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    Last Update Date     |    04/22/2015
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Provider Practice Location Address
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    Address Line         |    1301 POTOMAC SCHOOL RD 
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    City                 |    MC LEAN
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    State                |    VA
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    Zip                  |    22101-2350
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    Country              |    US
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    Telephone            |    703-356-4100
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    610 N IMBODEN ST APT 401 
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    City                 |    ALEXANDRIA
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    State                |    VA
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    Zip                  |    22304-5498
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    Country              |    US
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    Telephone            |    757-343-7427
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    
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