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General NPI Number Information
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NPI Number | 1679615793
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Entity Type | Organization
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Legal Business Name | THE CENTER FOR INTEGRATED MANUAL THERAPIES LLC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9159 RED BRANCH RD # F
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City | COLUMBIA
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State | MD
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Zip | 21045-2013
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Country | US
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Telephone | 410-740-2155
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 874
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City | COLUMBIA
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State | MD
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Zip | 21044-0874
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Country | US
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Telephone | 410-740-2155
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAREN A JOHNSON
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Credential | CMPT
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Telephone | 410-740-2155
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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 |
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License Number State |
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