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Individual
MATTHEW ALAN HENSLEE
Active
Individual
MATTHEW ALAN HENSLEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
OTA185
ID
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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