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Individual
JENNIFER A BRAKE
Active
Individual
JENNIFER A BRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01058572A
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
01058572A
IN
Other
Enumeration date
08/10/2006
Last updated
03/04/2016
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