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NPI 1750104493

NPI 1750104493 : REBECCA BRIGDON PT, DPT : DECATUR, GA

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General NPI Number Information
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    NPI Number           |    1750104493
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA BRIGDON PT, DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/01/2024
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    Last Update Date     |    11/01/2024
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Provider Practice Location Address
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    Address Line         |    1942 CLAIRMONT RD 
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    City                 |    DECATUR
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    State                |    GA
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    Zip                  |    30033-3406
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    Country              |    US
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    Telephone            |    404-248-1667
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1125 PLANTATION CIR 
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    City                 |    LINCOLNTON
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    State                |    GA
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    Zip                  |    30817-4708
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    Country              |    US
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    Telephone            |    
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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       |    PT017183
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    License Number State |    GA
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