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1245080043
TRAVIS BENJAMIN LYSAGHT
BIRMINGHAM, AL
NPI
1245080043
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-25
Last Update Date
2024-03-25
Business Address
TRAVIS BENJAMIN LYSAGHT
625 19TH ST S
BIRMINGHAM, AL 35233-1900
Phone number: 205-934-5631
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Mailing Address
TRAVIS BENJAMIN LYSAGHT
625 19TH ST S
BIRMINGHAM, AL 35233-1900
Phone number: 205-934-5631
Copy
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