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Individual
DR. MICHAEL IRELAND
Active
Individual
DR. MICHAEL IRELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
036655
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
262053421
TAX ID
NY
Enumeration date
08/15/2013
Last updated
08/15/2013
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