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Individual
DR. JONATHAN DAVID TAIT
Active
Individual
DR. JONATHAN DAVID TAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
005503
AZ
208VP0000X
Pain Medicine Physician
005503
AZ
Other
Enumeration date
11/06/2007
Last updated
02/28/2014
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