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General NPI Number Information
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NPI Number | 1760694293
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Entity Type | Individual
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Provider Name | MELISSA ANNE HUBAND PTA
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1585 3RD ST BLDG 285
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City | FORT JOHNSON
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State | LA
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Zip | 71459-5102
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Country | US
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Telephone | 337-531-3517
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 SW WESTMINISTER RD
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City | BLUE SPRINGS
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State | MO
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Zip | 64014-3556
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Country | US
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Telephone | 816-224-0014
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2006003821
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License Number State | MO
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