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General NPI Number Information
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NPI Number | 1912771999
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Entity Type | Individual
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Provider Name | ANGUS HUGHES LMT
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Gender | Male
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 417 E VEATCH ST
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City | MOSCOW
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State | ID
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Zip | 83843-3570
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Country | US
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Telephone | 208-476-9217
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Fax |
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Provider Business Mailing Address
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Address Line | 1893 TOM HO RD
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City | OROFINO
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State | ID
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Zip | 83544-6061
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Country | US
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Telephone | 208-476-9217
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MAS-5185
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License Number State | ID
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