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Individual
MR. BRYAN V LICH
Active
Individual
MR. BRYAN V LICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
169
GA
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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