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Individual
MR. GLENN EDWARD LAVALLEE
Active
Individual
MR. GLENN EDWARD LAVALLEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
026269-1
NY
Other
Enumeration date
11/05/2008
Last updated
05/28/2010
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