Individual
MR. WILLIE CARSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2730 LOIS ST # 1, PORTAGE, IN 46368-3532
(219) 654-3019
(219) 406-0162
Mailing address
2730 LOIS ST # 1, PORTAGE, IN 46368-3532
(219) 654-3019
(219) 406-0162
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
04/25/2025
Last updated
04/25/2025
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