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Individual
LUKE MATHISON
Active
Individual
LUKE MATHISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070022430
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLIED FOR
—
IL
Enumeration date
08/17/2016
Last updated
08/20/2016
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