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Individual
JERRY CHI CHUAN FANG
Active
Individual
JERRY CHI CHUAN FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
283804
MA
208100000X
Physical Medicine & Rehabilitation Physician
MT202572
PA
Other
Enumeration date
06/26/2012
Last updated
06/17/2021
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