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1780116210
SHELBIE JEAN HACKETT
MOSCOW, ID
NPI
1780116210
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2017-04-03
Last Update Date
2017-04-03
Business Address
SHELBIE JEAN HACKETT ATS
411 S ALMON ST # 1
MOSCOW, ID 83843-2219
Phone number: 208-514-9689
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Mailing Address
SHELBIE JEAN HACKETT ATS
411 S ALMON ST # 1
MOSCOW, ID 83843-2219
Phone number: 208-514-9689
Copy
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