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1568505592
GARY WALLER
STERLING HEIGHTS, MI
NPI
1568505592
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2007-02-15
Last Update Date
2007-07-08
Business Address
Mr. GARY WALLER ATC
6220 1 AND A HALF HALF MILE ROAD
STERLING HEIGHTS, MI 48314
Phone number: 586-731-6603
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Mailing Address
Mr. GARY WALLER ATC
13781 IRONWOOD DR
SHELBY TOWNSHIP, MI 48315-4226
Phone number:
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