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Individual
MR. GARY WALLACE SLATER III
Active
Individual
MR. GARY WALLACE SLATER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
129713
FL
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
Other
Enumeration date
02/01/2013
Last updated
05/21/2024
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