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Individual
DEVONTE LEGGETT
Active
Individual
DEVONTE LEGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
L2401639230303
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H070127
DONT HAVE ONE
WI
Enumeration date
09/08/2021
Last updated
08/12/2022
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