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Individual
MR. SCOTT RAY BERRY
Active
Individual
MR. SCOTT RAY BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN139129
CA
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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