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Individual
KELLY DEAN MAGUIRE
Active
Individual
KELLY DEAN MAGUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6120
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6120
LICENSE
OR
Enumeration date
12/18/2020
Last updated
12/18/2020
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