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General NPI Number Information
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NPI Number | 1710550579
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Entity Type | Individual
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Provider Name | KILY CHANTEL GILBERT ATC, CSCS, LAT
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Gender | Female
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 13655 BRONCOS PKWY
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City | ENGLEWOOD
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State | CO
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Zip | 80112-4150
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Country | US
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Telephone | 541-643-5759
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Fax |
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Provider Business Mailing Address
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Address Line | 3053 S QUINTERO WAY
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City | AURORA
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State | CO
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Zip | 80013-2250
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Country | US
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Telephone | 541-643-5759
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT.0002335
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License Number State | CO
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