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NPI 1750562245

NPI 1750562245 : RACHEL DAWN BUTLER ATC : ALAMOSA, CO

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General NPI Number Information
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    NPI Number           |    1750562245
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL DAWN BUTLER ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/26/2007
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    Last Update Date     |    11/26/2007
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Provider Practice Location Address
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    Address Line         |    208 EDGEMONT BLVD 
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    City                 |    ALAMOSA
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    State                |    CO
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    Zip                  |    81101-2373
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    Country              |    US
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    Telephone            |    719-587-7431
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    Fax                  |    719-587-7706
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Provider Business Mailing Address
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    Address Line         |    208 EDGEMONT BLVD 
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    City                 |    ALAMOSA
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    State                |    CO
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    Zip                  |    81101-2373
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    Country              |    US
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    Telephone            |    719-587-7431
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    Fax                  |    719-587-7706
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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       |    
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    License Number State |    MI
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