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General NPI Number Information
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NPI Number | 1902498298
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Entity Type | Organization
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Legal Business Name | HYPERBARIC THERAPY CLINIC OF INDIANA, LLC
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 14555 HAZEL DELL PKWY STE 140B
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City | CARMEL
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State | IN
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Zip | 46033-7000
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Country | US
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Telephone | 317-418-4702
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Fax |
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Provider Business Mailing Address
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Address Line | 605 PIEDMONT DR
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City | WESTFIELD
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State | IN
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Zip | 46074-8826
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Country | US
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Telephone | 317-418-4702
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KATHLEEN L CLARK
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Credential | JD
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Telephone | 317-418-4702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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