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Individual
KATRENA CARD
Active
Individual
KATRENA CARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, CWS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070016236
IL
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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