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General NPI Number Information
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NPI Number | 1750987624
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Entity Type | Individual
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Provider Name | KYLIE MANN DPT
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Gender | Female
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 9660 HAVEN AVE STE 130
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5897
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Country | US
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Telephone | 909-269-5127
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Fax |
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Provider Business Mailing Address
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Address Line | 5664 KATE WAY UNIT 5
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City | FONTANA
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State | CA
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Zip | 92336-4675
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Country | US
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Telephone | 909-638-3969
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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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