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1114641370
BRIAN A WADE
GRANTS PASS, OR
NPI
1114641370
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: FL 11015250)
Enumeration Date
2022-09-30
Last Update Date
2022-09-30
Business Address
BRIAN A WADE
500 SW RAMSEY AVE
GRANTS PASS, OR 97527-5554
Phone number: 541-472-7430
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Mailing Address
BRIAN A WADE
3480 EXETER CT
BELLE ISLE, FL 32812-6029
Phone number: 407-491-5254
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