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Individual
RUSSELL STRAM
Active
Individual
RUSSELL STRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, LAC
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
003039
NY
225100000X
Physical Therapist
Primary
020372
NY
Other
Enumeration date
02/27/2009
Last updated
01/12/2017
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