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Individual

ANNE RENEE HEREDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
8161 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 449-3685
(843) 449-2746
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7652
SC

Other

Enumeration date
10/03/2017
Last updated
10/03/2017
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