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1134222797
GLENICE M CARLSON
FARGO, ND
NPI
1134222797
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ND PAC0129)
Enumeration Date
2006-09-07
Last Update Date
2007-07-08
Business Address
Mrs. GLENICE M CARLSON PAC
510 4TH ST S PRAIRIE ST JOHNS
FARGO, ND 58103
Phone number: 701-476-7239
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Mailing Address
Mrs. GLENICE M CARLSON PAC
2320 124 AVE S
HORACE, ND 58047
Phone number: 701-476-7239
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