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Individual
JAIME SO
Active
Individual
JAIME SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070015815
IL
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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