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1386054468
CLARK SEBASTIAN SHIRLEY
MESA, AZ
NPI
1386054468
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: AZ 1142)
Enumeration Date
2014-04-29
Last Update Date
2014-04-29
Business Address
Mr. CLARK SEBASTIAN SHIRLEY AT, ATC
7311 E SOUTHERN AVE APT 2034
MESA, AZ 85209-2712
Phone number: 413-348-3145
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Mailing Address
Mr. CLARK SEBASTIAN SHIRLEY AT, ATC
7311 E SOUTHERN AVE APT 2034
MESA, AZ 85209-2712
Phone number: 413-348-3145
Copy
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