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1427540731
SAM BROSSEAU
MOSCOW, ID
NPI
1427540731
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2018-06-01
Last Update Date
2018-06-01
Business Address
SAM BROSSEAU
875 PERIMETER DR # MS 2401
MOSCOW, ID 83844-9803
Phone number: 206-335-6098
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Mailing Address
SAM BROSSEAU
13022 15TH AVE NE
SEATTLE, WA 98125-4017
Phone number: 206-335-6098
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