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Individual
MR. KENNETH PAUL FITTRO
Active
Individual
MR. KENNETH PAUL FITTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003112
MI
363AM0700X
Medical Physician Assistant
5601003112
MI
Other
Enumeration date
06/11/2007
Last updated
06/01/2010
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