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General NPI Number Information
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NPI Number | 1538709522
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Entity Type | Individual
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Provider Name | CRAIG ROBERT LUCE PT
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Gender | Male
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 528 WASHINGTON HWY
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City | MORRISVILLE
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State | VT
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Zip | 05661-8973
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Country | US
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Telephone | 802-888-8303
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Fax | 802-851-5024
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Provider Business Mailing Address
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Address Line | 50 N UNDERHILL STATION RD
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City | UNDERHILL
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State | VT
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Zip | 05489-9609
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Country | US
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Telephone | 802-238-8960
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 040.0003733
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License Number State | VT
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