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Individual
KELLY MARIE BUFFORD
Active
Individual
KELLY MARIE BUFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070015713
IL
2255A2300X
Athletic Trainer
096.001984
IL
Other
Enumeration date
06/12/2007
Last updated
01/17/2024
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