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1275557498
WADE CARLSON
PEORIA, IL
NPI
1275557498
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 036101444)
Enumeration Date
2006-07-27
Last Update Date
2012-10-12
Business Address
Dr. WADE CARLSON MD
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614-4686
Phone number: 309-683-6600
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Mailing Address
Dr. WADE CARLSON MD
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614-4686
Phone number: 309-683-6600
Copy
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