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1336280361
TRAVIS GREEN
OAK PARK HEIGHTS, MN
NPI
1336280361
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN 1423)
Enumeration Date
2007-02-11
Last Update Date
2007-07-08
Business Address
-- TRAVIS GREEN ATR
5595 MEMORIAL AVE N
OAK PARK HEIGHTS, MN 55082-1091
Phone number: 651-439-4488
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Mailing Address
-- TRAVIS GREEN ATR
8919 JANERO AVE S
COTTAGE GROVE, MN 55016-3419
Phone number: 651-214-4593
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