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Individual

MR. DAVID WALTER BRISTOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP PAC

Contact information

Practice address
111 RALEY BLVD, SUITE 140, CHICO, CA 95928-8351
(530) 345-9455
Mailing address
111 RALEY BLVD, SUITE 140, CHICO, CA 95928-8351
(530) 345-9455

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13525
CA
363LF0000X
Family Nurse Practitioner
487125
CA

Other

Enumeration date
07/12/2006
Last updated
11/09/2009
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