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General NPI Number Information
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NPI Number | 1508688813
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Entity Type | Individual
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Provider Name | BRIAN KEENE BS, LMT, CPT, CAFS
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Gender | Male
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 7120 E ORCHARD RD STE 110
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City | CENTENNIAL
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State | CO
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Zip | 80111
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Country | US
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Telephone | 303-771-3329
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Fax |
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Provider Business Mailing Address
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Address Line | 2575 SOUTH SYRACUSE WAY APT L303
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City | DENVER
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State | CO
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Zip | 80231
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Country | US
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Telephone | 720-673-2915
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0021273
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License Number State | CO
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