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1043571904
EVAN ROUBAL
CHAMPLIN, MN
NPI
1043571904
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2012-06-06
Last Update Date
2012-06-06
Business Address
-- EVAN ROUBAL
12054 MISSISSIPPI DR N
CHAMPLIN, MN 55316-2110
Phone number: 760-725-5298
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Mailing Address
-- EVAN ROUBAL
12054 MISSISSIPPI DRIVE
CHAMPLIN, MN 55316
Phone number: 760-725-5298
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