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NPI 1528200375

NPI 1528200375 : JOSHUA M DREHER MS, ATC : BOISE, ID

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General NPI Number Information
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    NPI Number           |    1528200375
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    Entity Type          |    Individual 
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    Provider Name        |    JOSHUA M DREHER MS, ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/25/2009
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    Last Update Date     |    03/25/2009
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Provider Practice Location Address
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    Address Line         |    1910 UNIVERSITY DR 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83725-0001
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    Country              |    US
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    Telephone            |    208-954-4089
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1910 UNIVERSITY DR 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83725-0001
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    Country              |    US
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    Telephone            |    208-954-4089
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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       |    AT-341
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    License Number State |    ID
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