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Individual
KRISTA SHALEE LOOMIS TAN
Active
Individual
KRISTA SHALEE LOOMIS TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
26407
CA
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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