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NPI 1558636068

NPI 1558636068 : NOELLE SCHIELER MS, ATC, LAT : MEDIA, PA

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General NPI Number Information
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    NPI Number           |    1558636068
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    Entity Type          |    Individual 
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    Provider Name        |    NOELLE SCHIELER MS, ATC, LAT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/16/2012
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    Last Update Date     |    03/16/2012
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Provider Practice Location Address
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    Address Line         |    1068 W BALTIMORE PIKE # 19063 
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    City                 |    MEDIA
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    State                |    PA
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    Zip                  |    19063-5104
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    Country              |    US
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    Telephone            |    610-566-9400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    171 BLACKBURN AVE 
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    City                 |    LANSDOWNE
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    State                |    PA
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    Zip                  |    19050-1418
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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       |    RT004370
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    License Number State |    PA
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