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General NPI Number Information
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NPI Number | 1639594831
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Entity Type | Organization
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Legal Business Name | JACKSON CLINICS LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 5900 FORT DR STE 208
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City | CENTREVILLE
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State | VA
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Zip | 20121-2425
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Country | US
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Telephone | 703-830-6360
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Fax | 703-830-6362
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Provider Business Mailing Address
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Address Line | 12701 FAIR LAKES CIR STE 102
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City | FAIRFAX
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State | VA
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Zip | 22033-4913
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Country | US
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Telephone | 888-889-6363
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Fax |
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Authorized Official
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Title or Position | VP, AUTHORIZED OFFICIAL
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Name | RICHARD BINSTEIN
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Credential | JD
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Telephone | 713-297-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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