NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1932420320
CLARK
TIMOTHY
VAUGHAN
PO BOX 3067
YUBA CITY
CA
959923067
1154527554
CORONADO
JAVIER
ROEL
450 CLARKSON AVE # 1262
BROOKLYN
NY
112032012
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