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1912215344
STEVEN MATT BUSH
JACKSON, MS
NPI
1912215344
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MS AT0489)
Enumeration Date
2010-09-20
Last Update Date
2010-09-20
Business Address
Mr. STEVEN MATT BUSH ATC
1325 E FORTIFICATION ST
JACKSON, MS 39202-2442
Phone number: 601-354-4488
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Mailing Address
Mr. STEVEN MATT BUSH ATC
1325 E FORTIFICATION ST
JACKSON, MS 39202-2442
Phone number:
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