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1013286152
LESLIE T. BASTIAN
MAPLETON, UT
NPI
1013286152
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2011-12-19
Last Update Date
2011-12-19
Business Address
Mrs. LESLIE T. BASTIAN AT,C.
366 E 1100 S
MAPLETON, UT 84664-5012
Phone number: 801-491-2199
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Mailing Address
Mrs. LESLIE T. BASTIAN AT,C.
366 E 1100 S
MAPLETON, UT 84664-5012
Phone number: 801-491-2199
Copy