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Individual
JAEL MCCANTS
Active
Individual
JAEL MCCANTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
045298
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045298
PT LICENSE NUMBER
NY
Enumeration date
12/18/2019
Last updated
12/18/2019
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