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Individual
HENRY FAJARDO
Active
Individual
HENRY FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
070014005
IL
225100000X
Physical Therapist
Primary
—
NULL
Other
Enumeration date
07/27/2011
Last updated
10/25/2013
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