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NPI 1487036042

NPI 1487036042 : RACHEL JENKINS ATC : THOMASVILLE, GA

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General NPI Number Information
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    NPI Number           |    1487036042
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL JENKINS ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/19/2015
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    Last Update Date     |    06/02/2016
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Provider Practice Location Address
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    Address Line         |    301 CARDINAL RIDGE RD 
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    City                 |    THOMASVILLE
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    State                |    GA
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    Zip                  |    31792-7176
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    Country              |    US
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    Telephone            |    513-745-9058
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2608 S KATHWOOD CIR 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45236-1026
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    Country              |    US
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    Telephone            |    
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    AT002819
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    License Number State |    GA
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