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1215400155
LORA LEE MATTOX
CENTRALIA, WA
NPI
1215400155
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: WA CG60864636)
Enumeration Date
2019-01-03
Last Update Date
2019-01-03
Business Address
LORA LEE MATTOX CPC
1723 KRESKY AVE
CENTRALIA, WA 98531-8985
Phone number: 360-559-6201
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Mailing Address
LORA LEE MATTOX CPC
1723 KRESKY AVE
CENTRALIA, WA 98531-8985
Phone number: 360-559-6201
Copy
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