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1336404946
LAWRENCE WAYNE BASTBERG
FORT MYERS, FL
NPI
1336404946
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-07-10
Last Update Date
2012-07-10
Business Address
Mr. LAWRENCE WAYNE BASTBERG
2789 ORTIZ AVE
FORT MYERS, FL 33905-7806
Phone number: 239-275-3222
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Mailing Address
Mr. LAWRENCE WAYNE BASTBERG
2789 ORTIZ AVE
FORT MYERS, FL 33905-7806
Phone number: 239-275-3222
Copy
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