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Individual
SHANE KOOKEN-HOVER
Active
Individual
SHANE KOOKEN-HOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19795
OR
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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