Individual
MR. CHARLES LEROY WILK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC.
Contact information
Practice address
4511 SE HAWTHORNE BLVD, SUITE 214, PORTLAND, OR 97215-3170
(503) 241-0042
Mailing address
4511 SE HAWTHORNE BLVD, SUITE 214, PORTLAND, OR 97215-3170
(503) 241-0042
(503) 241-0052
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00212
OR
Other
Enumeration date
09/08/2008
Last updated
08/07/2013
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