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1568719821
LARRY ODELL NEELY
SAN DIEGO, CA
NPI
1568719821
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171000000X Military Health Care Provider
Enumeration Date
2012-08-06
Last Update Date
2012-08-06
Business Address
Mr. LARRY ODELL NEELY idc
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-5291
Phone number: 619-532-6195
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Mailing Address
Mr. LARRY ODELL NEELY idc
10125 BORDELON ST
SAN DIEGO, CA 92124-3204
Phone number: 858-444-0108
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