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NPI 1760122881

NPI 1760122881 : TAYLOR ELIZABETH BISCHOFF LAT, ATC : MILWAUKEE, WI

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General NPI Number Information
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    NPI Number           |    1760122881
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    Entity Type          |    Individual 
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    Provider Name        |    TAYLOR ELIZABETH BISCHOFF LAT, ATC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/29/2022
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    Last Update Date     |    03/29/2022
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Provider Practice Location Address
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    Address Line         |    6801 N YATES RD 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53217-3945
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    Country              |    US
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    Telephone            |    262-370-4788
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1635 N WATER ST APT 301 
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    City                 |    MILWAUKEE
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    State                |    WI
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    Zip                  |    53202-3623
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    Country              |    US
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    Telephone            |    262-370-4478
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    
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