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1417581455
KYLE ERIC BISHOP
WENTZVILLE, MO
NPI
1417581455
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2021027368)
Enumeration Date
2020-02-28
Last Update Date
2021-12-30
Business Address
KYLE ERIC BISHOP LAT,ATC,BS
754 LUETKENHAUS BLVD
WENTZVILLE, MO 63385-3515
Phone number: 636-445-5001
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Mailing Address
KYLE ERIC BISHOP LAT,ATC,BS
3812 HOPEWELL RD
WENTZVILLE, MO 63385-5924
Phone number: 636-887-6674
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