TRAVIS BENJAMIN LYSAGHT

BIRMINGHAM, AL
NPI1245080043
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-03-25
Last Update Date2024-03-25
Business Address
TRAVIS BENJAMIN LYSAGHT
625 19TH ST S
BIRMINGHAM, AL 35233-1900
Phone number: 205-934-5631
Mailing Address
TRAVIS BENJAMIN LYSAGHT
625 19TH ST S
BIRMINGHAM, AL 35233-1900
Phone number: 205-934-5631
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