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Individual
JOE LOUIS WILSON
Active
Individual
JOE LOUIS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMP
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60442140
WA
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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