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Individual
JEANETTE LANE EMERSON
Active
Individual
JEANETTE LANE EMERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC , PTA,
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
540
MA
Other
Enumeration date
02/23/2007
Last updated
11/18/2014
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