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General NPI Number Information
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NPI Number | 1629638952
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Entity Type | Individual
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Provider Name | ALANA C VERNON PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 392 W MAIN AVE
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City | SISTERS
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State | OR
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Zip | 97759-0439
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Country | US
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Telephone | 541-316-0805
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Fax | 541-241-7670
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Provider Business Mailing Address
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Address Line | 371 SW UPPER TERRACE DR STE 3
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City | BEND
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State | OR
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Zip | 97702-1560
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Country | US
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Telephone | 541-316-0805
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Fax | 541-241-7670
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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 | 63291
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 63291
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License Number State | OR
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