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Individual

RAYNAL JEREMY WASHINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2920 SHALAKO DR APT 1806, FORT WORTH, TX 76116-9620
(817) 291-7912
Mailing address
2920 SHALAKO DR APT 1806, FORT WORTH, TX 76116-9620
(817) 291-7912

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary

Other

Enumeration date
01/23/2023
Last updated
01/23/2023
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