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General NPI Number Information
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NPI Number | 1407755028
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Entity Type | Individual
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Provider Name | SHAY JORDAN CADWELL
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Gender | Female
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 43323 COUNTY ROAD 14PP
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City | GUNNISON
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State | CO
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Zip | 81230-9402
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Country | US
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Telephone | 970-596-3083
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Fax |
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Provider Business Mailing Address
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Address Line | 43323 COUNTY ROAD 14PP
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City | GUNNISON
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State | CO
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Zip | 81230-9402
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Country | US
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Telephone | 970-596-3083
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 131990392
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License Number State | CO
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