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General NPI Number Information
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NPI Number | 1811879828
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Entity Type | Individual
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Provider Name | TREVOR JAMES MICHEL
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Gender |
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 5323 HENDRON RD
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City | GROVEPORT
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State | OH
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Zip | 43125-1055
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Country | US
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Telephone | 614-836-2349
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Fax | 614-836-2396
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Provider Business Mailing Address
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Address Line | 3463 LAKEVIEW TRL
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City | CANAL WINCHESTER
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State | OH
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Zip | 43110-8031
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Country | US
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Telephone | 419-944-4913
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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 | PTA012784
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License Number State | OH
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