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Individual
MARIO BLANQUEL
Active
Individual
MARIO BLANQUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
09/14/2016
Last updated
04/23/2018
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