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General NPI Number Information
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NPI Number | 1467277368
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Entity Type | Individual
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Provider Name | DANIELLE RAE RIDENBAUGH LPT
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 620 E MAIN ST
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City | WEST LAFAYETTE
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State | OH
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Zip | 43845-1267
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Country | US
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Telephone | 740-545-6355
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Fax | 740-545-5198
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Provider Business Mailing Address
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Address Line | 3460 GORSUCH RD
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City | NASHPORT
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State | OH
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Zip | 43830-9492
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Country | US
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Telephone | 740-294-9548
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7577
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License Number State | OH
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