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NPI 1750687315

NPI 1750687315 : SONDRA ROWLEY PTA : EAGAN, MN

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General NPI Number Information
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    NPI Number           |    1750687315
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    Entity Type          |    Individual 
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    Provider Name        |    SONDRA ROWLEY PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/31/2011
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    Last Update Date     |    04/30/2014
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Provider Practice Location Address
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    Address Line         |    3530 LEXINGTON AVE S APT 2 
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    City                 |    EAGAN
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    State                |    MN
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    Zip                  |    55123-1145
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    Country              |    US
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    Telephone            |    813-245-4858
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3530 LEXINGTON AVE S APT 2 
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    City                 |    EAGAN
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    State                |    MN
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    Zip                  |    55123-1145
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    Country              |    US
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    Telephone            |    813-245-4858
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    001364
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    License Number State |    IA
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Taxonomy #2
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    Taxonomy Code        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    2074749
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    License Number State |    TX
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Taxonomy #3
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    Taxonomy Code        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    A1512
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    License Number State |    MN
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