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General NPI Number Information
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NPI Number | 1508811985
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Entity Type | Individual
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Provider Name | PETER CHOLAKIS PT
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 8198 JOG RD. #100
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-2998
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Country | US
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Telephone | 561-742-5959
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Fax | 561-495-3886
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Provider Business Mailing Address
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Address Line | 15300 JOG ROAD SUITE 107-108
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2164
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Country | US
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Telephone | 561-742-5959
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Fax | 561-495-3886
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT19697
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License Number State | FL
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