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Individual

KELLY KUJABIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3644 COUNTY ROAD 1303, TYLER, TX 75704-5821
(903) 944-0444
Mailing address
3644 COUNTY ROAD 1303, TYLER, TX 75704-5821
(903) 944-0444

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
23814443
TX

Other

Enumeration date
08/18/2016
Last updated
08/18/2016
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