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Individual
MARY TRACEY ALYSON KAVANAUGH
Active
Individual
MARY TRACEY ALYSON KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P9204
NC
Other
Enumeration date
04/23/2010
Last updated
02/12/2024
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