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General NPI Number Information
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NPI Number | 1437058419
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Entity Type | Organization
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Legal Business Name | EXCELSENIOR FOOT CARE LLC
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 307 N WALNUT ST
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City | MURFREESBORO
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State | TN
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Zip | 37130-3623
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Country | US
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Telephone | 615-225-8911
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Fax | 615-713-3391
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Provider Business Mailing Address
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Address Line | PO BOX 331795
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City | MURFREESBORO
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State | TN
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Zip | 37133-1795
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Country | US
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Telephone | 615-225-8911
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Fax | 615-713-3391
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | MORGAN RICKABAUGH
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Credential |
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Telephone | 629-267-1285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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