CARL WALLACE LEDER

ROSEBURG, OR
NPI1619341724
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OR  PA174113)
Enumeration Date2015-12-01
Last Update Date2022-02-23
Business Address
CARL WALLACE LEDER PA-C
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-672-2691
Mailing Address
CARL WALLACE LEDER PA-C
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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