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Individual
TERA MICHELE CARLSON
Active
Individual
TERA MICHELE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN115079
OH
Other
Enumeration date
03/16/2008
Last updated
08/25/2014
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