Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Public Health, State or Local |
261QP0905X |
| NPI Number | 1598966459 |
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| Entity | Organization | ||||||||
| Organization subpart 1 | Not specified | ||||||||
| Enumeration date | 05/29/2007 | ||||||||
| Last updated | 07/08/2007 - About 19 years ago | ||||||||
| Identifiers |
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GLENDA S STIDHAM
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