Demographics
DOB: Nov 17, 1964
Sex: M
Status: active
Email: kayakfishingdetroit2025@gmail.com
Mobile: 9714473685
Home: 9714473685
Department: —
Primary Provider: Elliot Taxman
Last Synced: Jun 17, 2026, 2:13 PM
Address: 1655 S Elm St, CANBY, OR, 97013
No clinical chart records found.
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File: SMITH, Lance
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