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1497360002
IAN MAISONVILLE
PELHAM, AL
NPI
1497360002
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: TN 3645)
Enumeration Date
2020-09-10
Last Update Date
2020-10-02
Business Address
IAN MAISONVILLE
3017 INDIAN CREST DR
PELHAM, AL 35124-4701
Phone number: 205-529-0557
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Mailing Address
IAN MAISONVILLE
3017 INDIAN CREST DR
PELHAM, AL 35124-4701
Phone number:
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