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General NPI Number Information
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NPI Number | 1760475743
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Entity Type | Individual
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Provider Name | CECIL MICHAEL DUPRIEST PT, DPT, DC
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Gender | Male
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 4300 W 7TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5446
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Country | US
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Telephone | 501-257-6191
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Fax | 501-257-6419
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Provider Business Mailing Address
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Address Line | 4300 W 7TH (117/LR)
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-257-6191
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Fax | 501-257-6419
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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 | 515
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1125
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License Number State | AR
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