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Individual

AUTUMN CHANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
250 W MAIN ST STE 201, MOORESTOWN, NJ 08057-2365
(609) 257-8038
Mailing address
80 HENDERSON LN, WILLINGBORO, NJ 08046-1722
(609) 257-8038

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
224P00000X
Prosthetist
Primary

Other

Enumeration date
12/01/2022
Last updated
12/01/2022
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