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General NPI Number Information
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NPI Number | 1619308483
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Entity Type | Organization
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Legal Business Name | GOOD FAMILY PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 12/04/2013
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 15218 SUMMIT AVE # 300-702
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City | FONTANA
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State | CA
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Zip | 92336-0232
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Country | US
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Telephone | 909-471-8865
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Fax | 888-544-2759
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Provider Business Mailing Address
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Address Line | 15218 SUMMIT AVE # 300-702
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City | FONTANA
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State | CA
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Zip | 92336-0232
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Country | US
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Telephone | 909-471-8865
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Fax | 888-544-2759
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOEL ZAMORA
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Credential | PT
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Telephone | 909-471-8865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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