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General NPI Number Information
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NPI Number | 1770449225
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Entity Type | Individual
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Provider Name | KRYSTAL LYNN ROBERTSON ATC
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Gender | Female
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 121 CAHILL RD
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City | BRANSON
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State | MO
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Zip | 65616-2036
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Country | US
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Telephone | 417-348-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 186 ECHO VALLEY CIR
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City | REEDS SPRING
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State | MO
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Zip | 65737-8984
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Country | US
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Telephone | 417-880-2589
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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 | 2015035641
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License Number State | MO
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