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Individual
KENDALL P DESELMS
Active
Individual
KENDALL P DESELMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
005457
MO
207Q00000X
Family Medicine Physician
Primary
107636
MO
Other
Enumeration date
12/01/2005
Last updated
12/02/2010
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