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Individual

CALLIE MYRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1254 KAYAK CV, LUTZ, FL 33559-6744
(813) 279-0266
Mailing address
1254 KAYAK CV, LUTZ, FL 33559-6744
(813) 279-0266

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5220219
FL

Other

Enumeration date
08/11/2016
Last updated
08/11/2016
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