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General NPI Number Information
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NPI Number | 1629115290
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Entity Type | Individual
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Provider Name | LEANN RAQUEL ROTHE CRT-NPS
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1957 W MAIN ST
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City | SALEM
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State | VA
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Zip | 24153-3109
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Country | US
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Telephone | 540-375-7735
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Fax | 540-375-7736
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Provider Business Mailing Address
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Address Line | 1957 W MAIN ST
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City | SALEM
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State | VA
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Zip | 24153-3109
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Country | US
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Telephone | 540-375-7735
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Fax | 540-375-7736
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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 | 2279P1004X
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Taxonomy Name | Pulmonary Diagnostics Registered Respiratory Therapist
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License Number | 0117004587
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License Number State | VA
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