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NPI 1295127678

NPI 1295127678 : SYDNEY L KAPITANY ATC : EAU CLAIRE, WI

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General NPI Number Information
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    NPI Number           |    1295127678
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    Entity Type          |    Individual 
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    Provider Name        |    SYDNEY L KAPITANY ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/23/2015
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    Last Update Date     |    02/23/2015
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Provider Practice Location Address
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    Address Line         |    1324 E CLAIREMONT AVE 
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    City                 |    EAU CLAIRE
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    State                |    WI
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    Zip                  |    54701-4742
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    Country              |    US
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    Telephone            |    920-850-7939
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1324 E CLAIREMONT AVE 
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    City                 |    EAU CLAIRE
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    State                |    WI
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    Zip                  |    54701-4742
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    Country              |    US
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    Telephone            |    920-850-7939
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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       |    1486-39
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    License Number State |    WI
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