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Individual
SHANE GOBLIRSCH
Active
Individual
SHANE GOBLIRSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2533
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2533
BOARD OF MEDICAL PRACTICE
MN
Enumeration date
01/08/2016
Last updated
01/08/2016
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