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General NPI Number Information
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NPI Number | 1750800843
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Entity Type | Organization
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Legal Business Name | EDGE PHYSICAL MEDICINE INC
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 09/11/2017
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Provider Practice Location Address
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Address Line | 3090 ANGEL DR
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City | BETHEL
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State | OH
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Zip | 45106
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Country | US
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Telephone | 513-734-6555
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Fax |
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Provider Business Mailing Address
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Address Line | 1327 E KEMPER RD STE 3100B
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City | CINCINNATI
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State | OH
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Zip | 45246-3945
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Country | US
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Telephone | 513-670-0600
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Fax | 513-671-0999
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Authorized Official
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Title or Position | PRESIDENT
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Name | REBECCA SINGH
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Credential | DC
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Telephone | 513-671-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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