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Individual

BRIAN EDWARD CONWAY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
ATC; LAT

Contact information

Practice address
800 5TH AVE, SUITE 150, FORT WORTH, TX 76104-7300
(817) 810-7504
(817) 810-7501
Mailing address
2105 EDGEWOOD CT, ARLINGTON, TX 76013-5408
(817) 810-7504
(817) 810-7501

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0803
TX

Other

Enumeration date
08/22/2005
Last updated
07/08/2007
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