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Individual
JEFFREY DOUGLAS
Active
Individual
JEFFREY DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT, ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10977
MN
2255A2300X
Athletic Trainer
AL 4387
FL
Other
Enumeration date
04/06/2016
Last updated
03/08/2018
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