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General NPI Number Information
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NPI Number | 1639490147
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Entity Type | Organization
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Legal Business Name | CLINICA DE TERAPIA MANUAL, CRL
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 06/18/2010
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Provider Practice Location Address
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Address Line | 576 CESAR GONZALEZ AVE. SUITE 504, DORAL BANK CENTER
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-306-2764
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Fax |
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Provider Business Mailing Address
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Address Line | URB PASEO JACARANDA C/ UCAR 15031
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City | SANTA ISABEL
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State | PR
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Zip | 00757-9600
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Country | US
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Telephone | 787-306-2764
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NOEL A. MARTINEZ
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Credential |
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Telephone | 787-306-2764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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