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General NPI Number Information
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NPI Number | 1558291260
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Entity Type | Individual
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Provider Name | ZACKARY SCOTT PERRY
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Gender | Male
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Dates
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Enumeration Date | 05/22/2026
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Last Update Date | 05/22/2026
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Provider Practice Location Address
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Address Line | 320 S MAIN ST
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City | OLIVET
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State | MI
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Zip | 49076-9406
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Country | US
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Telephone | 269-749-7635
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Fax |
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Provider Business Mailing Address
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Address Line | 716 HOWARD LN
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City | HASTINGS
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State | MI
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Zip | 49058-2359
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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 | 2601003243
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License Number State | MI
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