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General NPI Number Information
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NPI Number | 1962141192
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Entity Type | Individual
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Provider Name | JOSEPH CARLEY DPT
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Gender | Male
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Dates
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Enumeration Date | 06/04/2022
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 550 W 465 N STE 504
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City | PROVIDENCE
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State | UT
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Zip | 84332-8014
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Country | US
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Telephone | 435-232-5773
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Fax |
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Provider Business Mailing Address
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Address Line | 205 WILLOW VALLEY RD
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City | LAMAR
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State | CO
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Zip | 81052-3841
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Country | US
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Telephone | 143-523-2577
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0016754
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12746560-2401
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License Number State | UT
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