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1407031750
SHIRO IWAE
JACKSONVILLE BEACH, FL
NPI
1407031750
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL PT10623)
Enumeration Date
2008-01-07
Last Update Date
2008-01-07
Business Address
Mr. SHIRO IWAE PT
1401 PENMAN RD SUITE C
JACKSONVILLE BEACH, FL 32250
Phone number: 904-241-9500
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Mailing Address
Mr. SHIRO IWAE PT
1653 LINKSIDE CT N
ATLANTIC BEACH, FL 32233
Phone number: 904-241-9500
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