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Individual

MATTHEW BRIAN BIANCUZZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1 TWINS WAY, MINNEAPOLIS, MN 55403-1418
(401) 489-3394
Mailing address
2654 W HORIZON RIDGE PKWY # B5-254, HENDERSON, NV 89052-2803
(401) 489-3394

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0506310
NV
2255A2300X
Athletic Trainer
Primary
3089
MN

Other

Enumeration date
04/09/2018
Last updated
04/09/2018
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