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NPI 1619328804

NPI 1619328804 : GENIS JUDE MONSANTO JR. PT, DPT : WASHINGTON, DC

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General NPI Number Information
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    NPI Number           |    1619328804
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    Entity Type          |    Individual 
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    Provider Name        |    GENIS JUDE MONSANTO JR. PT, DPT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/29/2016
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    Last Update Date     |    06/29/2016
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Provider Practice Location Address
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    Address Line         |    3800 RESERVOIR RD NW BLES BLDG. RM CG-12
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20007-2113
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    Country              |    US
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    Telephone            |    202-444-3692
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1515 15TH ST NW APT 213
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20005-1858
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    Country              |    US
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    Telephone            |    813-728-7229
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    PT871909
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    License Number State |    DC
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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       |    PT22016
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    License Number State |    MD
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