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General NPI Number Information
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NPI Number | 1487706677
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Entity Type | Individual
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Provider Name | ANGELA RAE JOWAISZAS P.T.
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Gender | Female
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1919 E MCKELLIPS RD SUITE 106
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City | MESA
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State | AZ
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Zip | 85203-2844
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Country | US
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Telephone | 602-418-7031
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Fax | 480-610-9811
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Provider Business Mailing Address
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Address Line | 2253 E HALE ST
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City | MESA
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State | AZ
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Zip | 85213-4012
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Country | US
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Telephone | 602-418-7031
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Fax | 480-610-9811
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 2089
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License Number State | AZ
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