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General NPI Number Information
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NPI Number | 1518807759
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Entity Type | Individual
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Provider Name | TARCISIO SANTOS MOREIRA PT, PHD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2026
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Last Update Date | 03/30/2026
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Provider Practice Location Address
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Address Line | 4250 GLENN AVE
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City | COVINGTON
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State | KY
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Zip | 41015-1641
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Country | US
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Telephone | 859-431-2244
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Fax |
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Provider Business Mailing Address
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Address Line | 1258 DAY CIR E
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City | MILFORD
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State | OH
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Zip | 45150-2303
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Country | US
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Telephone | 513-238-7126
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 022248
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 022248
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License Number State | OH
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