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1467189571
SHANE JAXYN LOGEN WILLIAMS
MOUNDSVILLE, WV
NPI
1467189571
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2022-08-08
Last Update Date
2022-08-08
Business Address
SHANE JAXYN LOGEN WILLIAMS
206 ASH AVE
MOUNDSVILLE, WV 26041-1536
Phone number: 681-588-7733
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Mailing Address
SHANE JAXYN LOGEN WILLIAMS
206 ASH AVE
MOUNDSVILLE, WV 26041-1536
Phone number: 681-588-7733
Copy
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