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Individual

MRS. KATHLEEN ANN SEGALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LMT

Contact information

Practice address
5025 9TH AVE N, ST PETERSBURG, FL 33710-6606
(727) 515-5358
(727) 865-6540
Mailing address
521 PINELLAS BAYWAY S APT 404, ST PETERSBURG, FL 33715-1999
(727) 515-5358
(727) 865-6540

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
MA0028278
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C8824
BLUE CROSS BLUE SHIELD
FL
Enumeration date
11/06/2008
Last updated
11/06/2008
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