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1083673115
JACK MICHAEL RAISANEN
DALLAS, TX
NPI
1083673115
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207ZN0500X Pathology, Neuropathology
(Licence: TX L1177)
Enumeration Date
2006-03-18
Last Update Date
2007-12-01
Business Address
Dr. JACK MICHAEL RAISANEN MD
5323 HARRY HINES BLVD
DALLAS, TX 75390-7208
Phone number: 214-648-1620
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Mailing Address
Dr. JACK MICHAEL RAISANEN MD
PO BOX 845347
DALLAS, TX 75284-5347
Phone number: 214-648-1620
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