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Individual

IDEAL PUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1855 CASSAT AVE, SUITE 11, JACKSONVILLE, FL 32210-1634
(904) 381-7060
(904) 381-7063
Mailing address
1855 CASSAT AVE, SUITE 11, JACKSONVILLE, FL 32210-1634
(904) 381-7060
(904) 381-7063

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
INVACARE 2-17-84
FL

Other

Enumeration date
08/12/2010
Last updated
08/12/2010
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