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Individual

MS. DAWN R LIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
3671 CHRISTOPHER PL, GROVE CITY, OH 43123-2428
(614) 204-4525
Mailing address
3671 CHRISTOPHER PL, GROVE CITY, OH 43123-2428
(614) 204-4525

Taxonomy

Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
33.019357
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
33.19357
STATE MEDICAL BD - MASSAGE THERAPY
OH
Enumeration date
09/24/2012
Last updated
09/24/2012
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