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Individual
MISTY MELISSA FEARON
Active
Individual
MISTY MELISSA FEARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0180361
NY
225100000X
Physical Therapist
40QA01236800
NJ
Other
Enumeration date
03/06/2007
Last updated
03/01/2011
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