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Individual

MR. BRENT SIPE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
22784 HIGHWAY 59, PORTER, TX 77365-6425
(281) 577-8630
Mailing address
22784 HIGHWAY 59, PORTER, TX 77365-6425
(281) 577-8630

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
069402691
2255A2300X
Athletic Trainer
AT1217
TX

Other

Enumeration date
01/05/2012
Last updated
01/04/2017
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