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General NPI Number Information
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NPI Number | 1437438546
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Entity Type | Organization
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Legal Business Name | COMPLETE REHAB & WELLNESS CENTER LLC
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Dates
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Enumeration Date | 08/06/2011
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Last Update Date | 08/06/2011
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Provider Practice Location Address
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Address Line | 9825 GILES RD SUITE F
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City | LA VISTA
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State | NE
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Zip | 68128-2927
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Country | US
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Telephone | 402-339-2283
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Fax | 402-339-2289
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Provider Business Mailing Address
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Address Line | 9825 GILES RD SUITE F
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City | LA VISTA
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State | NE
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Zip | 68128-2927
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Country | US
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Telephone | 402-339-2283
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Fax | 402-339-2289
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Authorized Official
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Title or Position | OWNER/CEO
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Name | PETER K. YOUNG
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Credential | D. C.
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Telephone | 402-339-2283
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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