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1730606096
MATTHEW EDWARD DEBERRY
LOGAN, UT
NPI
1730606096
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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
2017-08-28
Last Update Date
2022-07-21
Business Address
MATTHEW EDWARD DEBERRY
90 E 200 N
LOGAN, UT 84321
Phone number: 435-752-0750
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Mailing Address
MATTHEW EDWARD DEBERRY
90 E 200 N
LOGAN, UT 84321-4034
Phone number: 435-752-0750
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