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General NPI Number Information
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NPI Number | 1760037204
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Entity Type | Individual
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Provider Name | VICTORIA CHRISTINE PITTMAN DPT
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Gender | Female
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 534 S 5TH ST STE A
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City | MACCLENNY
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State | FL
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Zip | 32063-2602
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Country | US
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Telephone | 904-259-1649
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Fax |
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Provider Business Mailing Address
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Address Line | 7435 W SMOOTH BORE AVE
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City | GLEN ST MARY
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State | FL
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Zip | 32040-3135
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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 |
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License Number State | FL
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