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1992798607
NICOLE J DEVERTEUIL-WAGGONER
PLANTATION, FL
NPI
1992798607
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL PT18177)
Enumeration Date
2005-08-27
Last Update Date
2007-07-08
Business Address
Mrs. NICOLE J DEVERTEUIL-WAGGONER PT
12341 NW 18TH ST
PLANTATION, FL 33323-2122
Phone number: 954-478-4648
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Mailing Address
Mrs. NICOLE J DEVERTEUIL-WAGGONER PT
8100 NW 101ST AVE
TAMARAC, FL 33321-1235
Phone number: 954-258-0415
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