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General NPI Number Information
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NPI Number | 1518024256
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Entity Type | Individual
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Provider Name | BRIAN MITCHELL KUNICH P.T.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 825 E WARNER RD
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City | CHANDLER
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State | AZ
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Zip | 85225-0994
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Country | US
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Telephone | 480-722-0300
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Fax | 480-722-0302
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Provider Business Mailing Address
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Address Line | 18015 N 50TH ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-7612
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Country | US
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Telephone | 602-388-4236
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 5059
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License Number State | AZ
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