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Individual
MR. CLARENCE A STUPPARD SR.
Active
Individual
MR. CLARENCE A STUPPARD SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ADMINISTRATOR
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
16713601
PA
251E00000X
Home Health Agency
Primary
16713601
PA
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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