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General NPI Number Information
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NPI Number | 1669638698
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Entity Type | Organization
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Legal Business Name | REHAB OF BUCKHEAD
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 3165 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30305-1851
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Country | US
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Telephone | 770-795-0506
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 671962
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City | MARIETTA
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State | GA
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Zip | 30006-0033
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Country | US
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Telephone | 770-795-0506
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Fax |
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Authorized Official
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Title or Position | BILLING OFFICER
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Name | KEYSA MURRELL
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Credential |
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Telephone | 770-795-0506
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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 | 042114
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License Number State | GA
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