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General NPI Number Information
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NPI Number | 1689333460
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Entity Type | Individual
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Provider Name | JULIANNE GOZA ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 12/09/2021
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Last Update Date | 12/09/2021
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Provider Practice Location Address
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Address Line | 2800 E SPRING CREEK PKWY
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City | PLANO
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State | TX
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Zip | 75074-3300
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Country | US
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Telephone | 940-881-5630
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Fax |
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Provider Business Mailing Address
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Address Line | 305 RIVER FERN AVE APT 1115
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City | GARLAND
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State | TX
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Zip | 75040-2400
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Country | US
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Telephone | 210-842-1165
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | AT4869
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2083S0010X
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Taxonomy Name | Sports Medicine (Preventive Medicine) Physician
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License Number | AT4869
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT4869
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License Number State | TX
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