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General NPI Number Information
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NPI Number | 1306110101
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Entity Type | Organization
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Legal Business Name | ZIONS REHAB
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 1490 E FOREMASTER DR BLDG B
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City | ST GEORGE
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State | UT
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Zip | 84790-4510
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Country | US
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Telephone | 435-652-4205
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Fax | 435-688-2078
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Provider Business Mailing Address
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Address Line | 1490 E FOREMASTER DR BLDG B
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City | ST GEORGE
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State | UT
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Zip | 84790-4488
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Country | US
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Telephone | 435-652-4205
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Fax | 435-688-2078
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS JEN BOYACK
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Credential |
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Telephone | 435-652-4205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 4840
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License Number State | AZ
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