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Individual

JACK M STAGGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T., O.C.S.,

Contact information

Practice address
230 GRANT ROAD, SUITE B27, EAST WENATCHEE, WA 98802
(509) 884-1437
(509) 884-2811
Mailing address
230 GRANT RD, STE B27, EAST WENATCHEE, WA 98802-7715
(509) 884-2992

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005726
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7052665
WA
Enumeration date
03/16/2007
Last updated
07/28/2016
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