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1053809095
MICHAEL DOUGLAS MAVIS
PICKENS, SC
NPI
1053809095
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171W00000X Contractor
Enumeration Date
2018-04-25
Last Update Date
2018-04-25
Business Address
MICHAEL DOUGLAS MAVIS
233 MOUNTAIN ESTATES RD
PICKENS, SC 29671-8518
Phone number: 864-637-8770
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Mailing Address
MICHAEL DOUGLAS MAVIS
233 MOUNTAIN ESTATES RD
PICKENS, SC 29671-8518
Phone number:
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