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1275745309
PATRICK READ VANWAGONER
PROVO, UT
NPI
1275745309
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: UT 191104-4406)
Enumeration Date
2007-05-03
Last Update Date
2007-07-08
Business Address
-- PATRICK READ VANWAGONER CRNA
1067 N 500 W
PROVO, UT 84604
Phone number: 801-375-8049
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Mailing Address
-- PATRICK READ VANWAGONER CRNA
PO BOX 1727
PROVO, UT 84603-1727
Phone number: 801-375-8049
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