Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation |
261QR0400X | B4[14] | Rehabilitation Agency |
| NPI # | 1073901625 |
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| Entity | Organization | ||||
| Organization subpart 1 | Not specified | ||||
| Enumeration date | 01/06/2015 | ||||
| Last updated | 01/06/2015 - About 11 years ago | ||||
| Identifiers |
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JON GILLESPIE
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