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Individual
MAHANTIE THOMAS
Active
Individual
MAHANTIE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
211262
CA
Other
Enumeration date
02/04/2011
Last updated
06/15/2015
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