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General NPI Number Information
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NPI Number | 1922231117
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Entity Type | Organization
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Legal Business Name | ABSOLUTE PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 1523 E AMAR RD
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City | WEST COVINA
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State | CA
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Zip | 91792-1619
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Country | US
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Telephone | 626-839-9100
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Fax | 626-839-9106
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Provider Business Mailing Address
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Address Line | 1523 E AMAR RD
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City | WEST COVINA
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State | CA
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Zip | 91792-1619
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Country | US
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Telephone | 626-839-9100
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Fax | 626-839-9106
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MARK ANTHONY PALACIOS
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Credential | P.T.
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Telephone | 626-839-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 20833
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License Number State | CA
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