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1104409143
BRENDAN ALEXANDER BLACK
LEES SUMMIT, MO
NPI
1104409143
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MO 2021023467)
Enumeration Date
2021-04-28
Last Update Date
2024-04-05
Business Address
BRENDAN ALEXANDER BLACK PT, DPT
1321 SW MARKET ST
LEES SUMMIT, MO 64081-2904
Phone number: 816-607-7180
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Mailing Address
BRENDAN ALEXANDER BLACK PT, DPT
1321 SW MARKET ST
LEES SUMMIT, MO 64081-2904
Phone number: 816-607-7180
Copy
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