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Individual
RICHARD MEDINA
Active
Individual
RICHARD MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070025367
IL
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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