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NPI 1972058550

NPI 1972058550 : DINAH WEBB LMT/ NMT : TIFTON, GA

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General NPI Number Information
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    NPI Number           |    1972058550
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    Entity Type          |    Individual 
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    Provider Name        |    DINAH WEBB LMT/ NMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/24/2016
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    Last Update Date     |    08/24/2016
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Provider Practice Location Address
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    Address Line         |    401 RIDGE AVE N SUITE C
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    City                 |    TIFTON
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    State                |    GA
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    Zip                  |    31794-4391
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    Country              |    US
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    Telephone            |    229-520-2596
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    71 SPRINGHILL CHURCH RD 
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    City                 |    TIFTON
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    State                |    GA
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    Zip                  |    31793-6843
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    Country              |    US
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    Telephone            |    229-520-2596
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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       |    MT007816
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    License Number State |    GA
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