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General NPI Number Information
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NPI Number | 1982370771
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Entity Type | Individual
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Provider Name | JOHN M DELOSSANTOS OTR/L, MBA, RAC-CT
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Gender | Male
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 4904 WOODFIELD DR
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City | CARMEL
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State | IN
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Zip | 46033-9427
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Country | US
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Telephone | 317-752-2209
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Fax | 317-688-8015
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Provider Business Mailing Address
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Address Line | 4904 WOODFIELD DR
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City | CARMEL
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State | IN
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Zip | 46033-9427
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Country | US
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Telephone | 317-752-2209
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Fax | 317-688-8015
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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 | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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