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NPI 1528680568

NPI 1528680568 : DAVID BOOK PHARMD : BOISE, ID

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General NPI Number Information
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    NPI Number           |    1528680568
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID BOOK PHARMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/13/2020
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    Last Update Date     |    05/13/2020
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Provider Practice Location Address
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    Address Line         |    1707 N 26TH ST 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83702-0112
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    Country              |    US
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    Telephone            |    303-829-3976
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1707 N 26TH ST 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83702-0112
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    Country              |    US
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    Telephone            |    
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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       |    RPH029459
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    License Number State |    GA
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Taxonomy #2
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    Taxonomy Code        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    P8272
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    License Number State |    ID
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