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General NPI Number Information
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NPI Number | 1497134191
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Entity Type | Organization
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Legal Business Name | BREATHERESTORATION
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2237 WILSON ST UNIT A
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City | HOLLYWOOD
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State | FL
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Zip | 33020-2650
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Country | US
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Telephone | 206-498-9197
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Fax |
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Provider Business Mailing Address
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Address Line | 2237 WILSON ST UNIT A
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City | HOLLYWOOD
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State | FL
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Zip | 33020-2650
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Country | US
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Telephone | 206-498-9197
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KYLE A ROBERTS
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Credential | DC
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Telephone | 206-498-9197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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