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Individual
MR. SAMUEL WESLEY TICE JR.
Active
Individual
MR. SAMUEL WESLEY TICE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA21534
FL
Other
Enumeration date
03/27/2014
Last updated
03/27/2014
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