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Individual
AMIE-GAYLE G MIRAN
Active
Individual
AMIE-GAYLE G MIRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506462
NV
Other
Enumeration date
09/21/2017
Last updated
12/28/2017
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