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NPI 1508236167

NPI 1508236167 : MELISSA GEHLERT : CINCINNATI, OH

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General NPI Number Information
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    NPI Number           |    1508236167
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    Entity Type          |    Individual 
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    Provider Name        |    MELISSA GEHLERT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/25/2015
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    Last Update Date     |    09/25/2015
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Provider Practice Location Address
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    Address Line         |    3800 VICTORY PKWY 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45207-1035
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    Country              |    US
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    Telephone            |    513-476-3260
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3910 S MADISON AVE 
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    City                 |    NORWOOD
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    State                |    OH
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    Zip                  |    45212-4022
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    Country              |    US
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    Telephone            |    513-476-3260
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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 |    
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    OH
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