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1114500741
CODY LANE BERGMAN
LOUISVILLE, KY
NPI
1114500741
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-05-02
Last Update Date
2021-05-02
Business Address
Mr. CODY LANE BERGMAN
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202-1702
Phone number: 502-852-8696
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Mailing Address
Mr. CODY LANE BERGMAN
500 S PRESTON ST RM 305
LOUISVILLE, KY 40202-1702
Phone number: 502-852-8696
Copy
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