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1780328054
BRYAN GODBOUT
MEMPHIS, TN
NPI
1780328054
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TN 7578)
Enumeration Date
2022-04-23
Last Update Date
2022-04-23
Business Address
BRYAN GODBOUT
3535 KIRBY PKWY
MEMPHIS, TN 38115-3721
Phone number: 612-229-3615
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Mailing Address
BRYAN GODBOUT
1796 CRUMP AVE
MEMPHIS, TN 38107-4513
Phone number: 612-229-3615
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