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1528327954
BLAKE CARLSON
ST LOUIS PARK, MN
NPI
1528327954
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: WA MD60476887)
Enumeration Date
2012-05-04
Last Update Date
2018-05-24
Business Address
BLAKE CARLSON MD
5775 WAYZATA BLVD STE 190
ST LOUIS PARK, MN 55416
Phone number: 952-541-1840
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Mailing Address
BLAKE CARLSON MD
PO BOX 50095
SEATTLE, WA 98145-5095
Phone number: 206-543-6420
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