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Individual
MRS. KELLY BETTEZ DESIMONE
Active
Individual
MRS. KELLY BETTEZ DESIMONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
001024
RI
225100000X
Physical Therapist
Primary
01024
RI
Other
Enumeration date
06/07/2006
Last updated
02/15/2019
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