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1760458863
BRIAN MARTIN BUSANICH
CHICAGO, IL
NPI
1760458863
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096-002165)
Enumeration Date
2006-02-27
Last Update Date
2007-07-08
Business Address
Mr. BRIAN MARTIN BUSANICH M.S., A.T.C.
1503 W NELSON ST #3R
CHICAGO, IL 60657-3116
Phone number: 773-220-0812
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Mailing Address
Mr. BRIAN MARTIN BUSANICH M.S., A.T.C.
1503 W NELSON ST #3R
CHICAGO, IL 60657-3116
Phone number: 773-220-0812
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