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General NPI Number Information
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NPI Number | 1922320068
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Entity Type | Individual
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Provider Name | PATRICK MICHAEL BELLE-ISLE LMT
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Gender | Male
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 1018 NE 3RD ST STE: C
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City | MCMINNVILLE
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State | OR
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Zip | 97128-4403
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Country | US
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Telephone | 503-883-9375
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Fax | 503-427-7851
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Provider Business Mailing Address
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Address Line | 3051 BRITTANY DR
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City | FOREST GROVE
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State | OR
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Zip | 97116-3125
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Country | US
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Telephone | 503-430-7515
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 16514
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License Number State | OR
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