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Individual

SALLY JO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 724-7300
Mailing address
40 N KINGSHIGHWAY BLVD APT 7D, SAINT LOUIS, MO 63108-1354
(404) 290-9509

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2019018223
MO

Other

Enumeration date
06/19/2019
Last updated
06/25/2024
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