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1053760611
BRANDON WALCOTT-AYERS
MONMOUTH, OR
NPI
1053760611
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: OR 2000024240)
Enumeration Date
2016-06-05
Last Update Date
2019-05-14
Business Address
BRANDON WALCOTT-AYERS ATC
345 MONMOUTH AVE N
MONMOUTH, OR 97361-1329
Phone number: 503-838-8251
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Mailing Address
BRANDON WALCOTT-AYERS ATC
3755 SE 10TH AVE
PORTLAND, OR 97202-3713
Phone number: 925-212-1093
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