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Individual
PROF. BRIAN D. CARROLL
Active
Individual
PROF. BRIAN D. CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164003714
IL
133V00000X
Registered Dietitian
2014006008
MO
Other
Enumeration date
03/29/2014
Last updated
03/29/2014
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