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General NPI Number Information
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NPI Number | 1346657673
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Entity Type | Organization
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Legal Business Name | INTEGRATED THERAPY SOLUTIONS, LLC
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Dates
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Enumeration Date | 07/18/2014
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Last Update Date | 07/18/2014
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Provider Practice Location Address
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Address Line | 251 NORTHLAND DR NE
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City | ROCKFORD
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State | MI
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Zip | 49341-1041
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Country | US
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Telephone | 616-884-5827
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Fax | 616-884-5828
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Provider Business Mailing Address
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Address Line | PO BOX 545
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City | ROCKFORD
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State | MI
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Zip | 49341-0545
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Country | US
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Telephone | 616-884-5827
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Fax | 616-884-5828
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Authorized Official
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Title or Position | OWNER
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Name | MS. ERIN LEIGH BLOOMQUIST
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Credential | P.T.
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Telephone | 616-648-0099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 5501008415
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License Number State | MI
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