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Individual
MISS LARA ALANE EDWARDS
Active
Individual
MISS LARA ALANE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, ATC, LAT
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1275
AL
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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