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Individual
MR. GARY LEON BLACKBURN
Active
Individual
MR. GARY LEON BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
28897
CA
Other
Enumeration date
08/20/2006
Last updated
04/29/2014
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