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General NPI Number Information
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NPI Number | 1710664743
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Entity Type | Individual
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Provider Name | EMELIE Z SIA
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Gender | Female
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 23811 CHAGRIN BLVD STE 120
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City | BEACHWOOD
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State | OH
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Zip | 44122-5555
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Country | US
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Telephone | 216-682-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 510 W MAIN ST STE B
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City | CANFIELD
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State | OH
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Zip | 44406-1454
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Country | US
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Telephone | 480-401-1686
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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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