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General NPI Number Information
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NPI Number | 1275850299
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Entity Type | Individual
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Provider Name | ALICIA FLACH DPT
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Gender | Female
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Dates
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Enumeration Date | 04/30/2010
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Last Update Date | 12/12/2014
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Provider Practice Location Address
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Address Line | 901 ST. LOUIS ST
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-6443
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Country | US
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Telephone | 618-610-4420
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Fax |
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Provider Business Mailing Address
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Address Line | 901 SAINT LOUIS ST
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-1301
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Country | US
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Telephone | 618-610-4420
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.016893
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License Number State | IL
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