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1063022408
NATHAN SUMARSONO
DALLAS, TX
NPI
1063022408
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-07-31
Last Update Date
2020-07-31
Business Address
NATHAN SUMARSONO
5323 HARRY HINES BLVD
DALLAS, TX 75390-7201
Phone number: 214-648-2168
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Mailing Address
NATHAN SUMARSONO
5323 HARRY HINES BLVD
DALLAS, TX 75390-7201
Phone number: 214-648-2168
Copy
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