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Individual
BRIAN WENDELL SMITH
Active
Individual
BRIAN WENDELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
10024800
OR
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
07/27/2021
Last updated
04/10/2024
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