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General NPI Number Information
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NPI Number | 1932241452
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Entity Type | Organization
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Legal Business Name | ROBERT W. MAUTHE, M.D. P.C.
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4676 ROUTE 309
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City | CENTER VALLEY
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State | PA
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Zip | 18034-8200
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Country | US
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Telephone | 610-791-7690
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Fax | 610-791-7693
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Provider Business Mailing Address
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Address Line | 4676 ROUTE 309
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City | CENTER VALLEY
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State | PA
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Zip | 18034-8200
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Country | US
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Telephone | 610-791-7690
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Fax | 610-791-7693
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. LISA A BOESKEN
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Credential |
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Telephone | 610-791-7690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number | 036783E
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License Number State | PA
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