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General NPI Number Information
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NPI Number | 1700335684
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Entity Type | Organization
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Legal Business Name | SYMBIO PRO PT, LLC
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Dates
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Enumeration Date | 10/03/2016
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Last Update Date | 05/16/2022
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Provider Practice Location Address
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Address Line | 25 W 14TH ST FL 2
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City | NEW YORK
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State | NY
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Zip | 10011-7420
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Country | US
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Telephone | 917-310-5427
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Fax |
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Provider Business Mailing Address
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Address Line | 1215 BROADWAY APT 623
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City | ASTORIA
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State | NY
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Zip | 11106-4969
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Country | US
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Telephone | 646-320-0518
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL DIRECTOR
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Name | DR. CHAD WOODARD
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Credential | DPT
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Telephone | 917-310-5427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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