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NPI 1851440796

NPI 1851440796 : KREGG GEGORSKI P.T. : COLUMBUS, OH

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General NPI Number Information
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    NPI Number           |    1851440796
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    Entity Type          |    Individual 
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    Provider Name        |    KREGG GEGORSKI P.T.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/09/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1504 W 1ST AVE SUITE 220
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    City                 |    COLUMBUS
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    State                |    OH
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    Zip                  |    43212-3427
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    Country              |    US
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    Telephone            |    614-485-2347
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    Fax                  |    614-485-2561
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Provider Business Mailing Address
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    Address Line         |    847 ELLIS ST 
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    City                 |    PICKERINGTON
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    State                |    OH
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    Zip                  |    43147-9359
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    5711
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    License Number State |    OH
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