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Individual
CARRIE FANG
Active
Individual
CARRIE FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.A.
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
AC00000097
WA
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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