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Individual
SAMUEL CENTER
Active
Individual
SAMUEL CENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1101970-30
WI
163W00000X
Registered Nurse
2390967
MN
Other
Enumeration date
08/19/2022
Last updated
01/30/2024
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