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General NPI Number Information
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NPI Number | 1679708903
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Entity Type | Individual
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Provider Name | JASON RICHARD MITCHLER DPT
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Gender | Male
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 7950 MARTIN LOOP
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City | FORT BENNING
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State | GA
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Zip | 31905-5647
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Country | US
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Telephone | 706-544-2994
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Fax |
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Provider Business Mailing Address
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Address Line | 17890 E STEAMBOAT AVE BLDG 35
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City | BUCKLEY AFB
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State | CO
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Zip | 80011-9421
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Country | US
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Telephone | 720-847-4214
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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