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1750979852
TRYSTAN JAMES SELF
MOODY AFB, GA
NPI
1750979852
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date
2021-01-05
Last Update Date
2024-10-16
Business Address
TRYSTAN JAMES SELF IDMT
3280 MITCHELL BLVD
MOODY AFB, GA 31699-1541
Phone number: 229-257-2778
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Mailing Address
TRYSTAN JAMES SELF IDMT
3280 MITCHELL BLVD
MOODY AFB, GA 31699-1500
Phone number: 229-257-2778
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