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General NPI Number Information
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NPI Number | 1760990097
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Entity Type | Individual
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Provider Name | MICHAEL SANTOS OTD
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Gender | Male
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 01/22/2018
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Provider Practice Location Address
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Address Line | 2850 SPRINGDALE RD SW
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City | ATLANTA
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State | GA
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Zip | 30315-7802
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Country | US
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Telephone | 813-494-5426
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 170205
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City | ATLANTA
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State | GA
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Zip | 30317-0205
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 003530
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License Number State | GA
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