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1154835536
CASEY RYAN DIVIN
SAN ANTONIO, TX
NPI
1154835536
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX AP135899)
Enumeration Date
2017-11-21
Last Update Date
2021-01-20
Business Address
CASEY RYAN DIVIN
5414 FREDERICKSBURG RD STE 100A
SAN ANTONIO, TX 78229-3641
Phone number: 210-468-0800
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Mailing Address
CASEY RYAN DIVIN
20529 WIND SPGS
SAN ANTONIO, TX 78258-7457
Phone number:
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