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NPI 1619324860

NPI 1619324860 : BARBARA KAISER : NAMPA, ID

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General NPI Number Information
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    NPI Number           |    1619324860
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    Entity Type          |    Individual 
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    Provider Name        |    BARBARA KAISER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/18/2016
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    Last Update Date     |    05/18/2016
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Provider Practice Location Address
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    Address Line         |    430 W IOWA AVE 
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    City                 |    NAMPA
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    State                |    ID
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    Zip                  |    83686-2826
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    Country              |    US
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    Telephone            |    208-442-1123
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4882 N LAKESHORE PLACE 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83714
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    Country              |    US
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    Telephone            |    208-315-0776
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    MASG-452
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    License Number State |    ID
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