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1144637927
JASON KYLE CARRUTH
CONWAY, AR
NPI
1144637927
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: AR AT 084)
Enumeration Date
2014-07-14
Last Update Date
2014-07-14
Business Address
-- JASON KYLE CARRUTH ATC
550 CLUB LN SUITE 2
CONWAY, AR 72034-3681
Phone number: 501-932-0814
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Mailing Address
-- JASON KYLE CARRUTH ATC
68 DONNA KAY DR
GREENBRIER, AR 72058-9579
Phone number: 501-908-3117
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