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1659484483
TRAVIS CHARLES HEADLEY
COEUR D ALENE, ID
NPI
1659484483
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA406)
Enumeration Date
2006-08-16
Last Update Date
2023-12-05
Business Address
TRAVIS CHARLES HEADLEY PA
850 W IRONWOOD DR SUITE 202
COEUR D ALENE, ID 83814-4903
Phone number: 208-664-2175
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Mailing Address
TRAVIS CHARLES HEADLEY PA
850 W IRONWOOD DR SUITE 202
COEUR D ALENE, ID 83814-4903
Phone number: 208-664-2175
Copy
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