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Individual
TRAVIS WHALEN
Active
Individual
TRAVIS WHALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20003
OR
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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