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Individual
TYLER JACK BRANHAM
Active
Individual
TYLER JACK BRANHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT6761
TX
363A00000X
Physician Assistant
Primary
PA14675
TX
Other
Enumeration date
06/29/2021
Last updated
08/11/2021
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