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General NPI Number Information
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NPI Number | 1326233107
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Entity Type | Individual
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Provider Name | VALERIE ERNST PT
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Gender | Female
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 901 W MORTON AVE S16A
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City | JACKSONVILLE
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State | IL
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Zip | 62650-3287
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Country | US
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Telephone | 217-588-2100
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Fax | 217-523-1489
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Provider Business Mailing Address
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Address Line | PO BOX 3428
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City | SPRINGFIELD
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State | IL
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Zip | 62708-3428
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Country | US
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Telephone | 800-577-5368
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Fax | 217-757-2021
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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 | 70016000
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License Number State | IL
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