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General NPI Number Information
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NPI Number | 1609033414
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Entity Type | Individual
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Provider Name | RUTH M ROSS PT
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Gender | Female
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 2716 WEST GORE BLVD SUITE D
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City | LAWTON
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State | OK
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Zip | 73505
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Country | US
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Telephone | 580-355-1766
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Fax | 580-357-8750
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Provider Business Mailing Address
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Address Line | PO BOX 6626
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City | LAWTON
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State | OK
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Zip | 73506-0626
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Country | US
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Telephone | 580-355-1766
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Fax | 580-357-5780
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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 | 655
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License Number State | OK
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