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General NPI Number Information
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NPI Number | 1619416971
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Entity Type | Individual
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Provider Name | JACQUELINE A REID RT
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Gender | Female
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 1501 RIVERSIDE DR SUITE 350
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City | CHATTANOOGA
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State | TN
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Zip | 37406-4309
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Country | US
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Telephone | 423-386-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 8451 JAY TRENT CT
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City | OOLTEWAH
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State | TN
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Zip | 37363-5751
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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 | 2278H0200X
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Taxonomy Name | Home Health Certified Respiratory Therapist
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License Number | CRT0000005760
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License Number State | TN
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