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General NPI Number Information
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NPI Number | 1558566521
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Entity Type | Individual
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Provider Name | CLIFFORD MATTHEW LEACH DPT
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Gender | Male
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 6045 ALMA DR STE 320
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City | MCKINNEY
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State | TX
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Zip | 75070
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Country | US
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Telephone | 972-569-9050
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Fax | 972-569-9076
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Provider Business Mailing Address
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Address Line | 6045 ALMA RD STE 320
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City | MCKINNEY
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State | TX
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Zip | 75070-2188
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Country | US
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Telephone | 972-569-9050
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Fax | 972-569-9076
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1172280
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License Number State | TX
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