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General NPI Number Information
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NPI Number | 1639390834
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Entity Type | Organization
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Legal Business Name | SUMMIT THERAPY SERVICES LLC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 1500 AVENUE H
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City | ELY
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State | NV
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Zip | 89301-2615
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Country | US
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Telephone | 775-289-3467
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 151674
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City | ELY
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State | NV
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Zip | 89315-1208
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Country | US
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Telephone | 775-289-3467
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. VINCENT K WINDOUS
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Credential | MPT
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Telephone | 775-289-3467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | LLC2435-2002
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | LLC2435-2002
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License Number State | NV
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