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1205487444
SHANE DAVID FRASHER
MILWAUKEE, WI
NPI
1205487444
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: WI 469-27)
Enumeration Date
2019-09-27
Last Update Date
2019-09-27
Business Address
Mr. SHANE DAVID FRASHER COTA
3540 S 43RD ST
MILWAUKEE, WI 53220-1502
Phone number: 414-328-2104
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Mailing Address
Mr. SHANE DAVID FRASHER COTA
3540 S 43RD ST
MILWAUKEE, WI 53220-1502
Phone number: 414-328-2104
Copy
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