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Individual
MR. MICHAEL ANTON FACKLMANN
Active
Individual
MR. MICHAEL ANTON FACKLMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNFA
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
0001206848
VA
Other
Enumeration date
10/22/2009
Last updated
10/22/2009
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