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Individual
BRAD LESTER NELSON
Active
Individual
BRAD LESTER NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC-L
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2378103-4810
UT
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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