WAYNE A CARLSON, MD
Emergency Medical Service at Grange Rd, Glendora, MI

License number
Michigan 064990
Category
Osteopathic Medicine
Type
Emergency Medical Services
Address
Address
2122 Grange Rd, Glendora, MI 49107
Phone
(269) 471-5186
(269) 471-5086 (Fax)
National Provider ID: 1548202450
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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WAYNE A. CARLSON, M.D., PC

Glendora, MI

Registration:
Jun 23, 1997
Addresses:
2122 Grange Rd, Buchanan, MI 49107 (Physical)
Michigan (Mailing)
State ID:
474539
Business type:
Domestic Professional Service Corporation
Agent:
Wayne A Carlson Md

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