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General NPI Number Information
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NPI Number | 1629778980
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Entity Type | Individual
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Provider Name | DONALD MACLEOD DPT, PT, MBA
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Gender | Male
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 2800 E ROCK HAVEN RD
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City | HARRISONVILLE
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State | MO
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Zip | 64701-4411
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Country | US
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Telephone | 168-870-3048
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Fax | 816-887-0305
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Provider Business Mailing Address
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Address Line | 2800 E ROCK HAVEN RD
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City | HARRISONVILLE
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State | MO
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Zip | 64701-4411
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Country | US
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Telephone | 816-887-0304
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Fax | 816-887-0305
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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 | 2017026957
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License Number State | MO
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