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1770167546
MACK KENNETH WINGREEN
FREDERICK, MD
NPI
1770167546
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MD A4884)
Enumeration Date
2021-05-07
Last Update Date
2021-05-07
Business Address
MACK KENNETH WINGREEN
7407 WILLOW RD
FREDERICK, MD 21702-2500
Phone number: 301-644-5600
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Mailing Address
MACK KENNETH WINGREEN
6617 HIGH BEACH CT E
NEW MARKET, MD 21774-6852
Phone number: 410-530-3361
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