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1568216596
BLAKE ORION THEABOLD
CORPUS CHRISTI, TX
NPI
1568216596
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-04-16
Last Update Date
2024-04-16
Business Address
BLAKE ORION THEABOLD DO
600 ELIZABETH ST # 9B9.209
CORPUS CHRISTI, TX 78404-2235
Phone number: 361-861-1864
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Mailing Address
BLAKE ORION THEABOLD DO
600 ELIZABETH ST # 9B9.209
CORPUS CHRISTI, TX 78404-2235
Phone number:
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