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General NPI Number Information
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NPI Number | 1710542980
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Entity Type | Organization
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Legal Business Name | SOUTHEAST OHIO REHABILITATION SERVICES, LLC
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Dates
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Enumeration Date | 05/03/2019
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 145 N 7TH ST STE B
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City | CAMBRIDGE
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State | OH
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Zip | 43725-2320
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Country | US
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Telephone | 740-995-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 145 N 7TH ST STE B
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City | CAMBRIDGE
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State | OH
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Zip | 43725-2320
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Country | US
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Telephone | 740-995-8200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW NELSON
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Credential | DPT
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Telephone | 740-525-5611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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