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1225868797
CLAY BURT BROADWELL
BISMARCK, ND
NPI
1225868797
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X
Enumeration Date
2024-08-07
Last Update Date
2024-08-07
Business Address
CLAY BURT BROADWELL
2130 S 12TH ST APT 137
BISMARCK, ND 58504-3144
Phone number: 701-840-1506
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Mailing Address
CLAY BURT BROADWELL
2130 S 12TH ST APT 137
BISMARCK, ND 58504-3144
Phone number: 701-840-1506
Copy
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