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Individual
MR. CARLOS DANIEL LUIS
Active
Individual
MR. CARLOS DANIEL LUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003450
IL
2255A2300X
Athletic Trainer
2013023627
MO
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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