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1104212018
TYRELL SCURLOCK
SAINT LOUIS, MO
NPI
1104212018
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
(Licence: MO 2003020843)
Enumeration Date
2015-04-08
Last Update Date
2015-04-08
Business Address
-- TYRELL SCURLOCK
11960 WESTLINE INDUSTRIAL DR 201
SAINT LOUIS, MO 63146-3209
Phone number: 314-575-8163
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Mailing Address
-- TYRELL SCURLOCK
PO BOX 23331
SAINT LOUIS, MO 63156-3331
Phone number: 314-575-8163
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