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Individual

BRIAN RICHARD CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(614) 371-8434
Mailing address
1585 3RD ST BLDG 285, FORT JOHNSON, LA 71459-5102
(614) 371-8434

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT018930
OH
363A00000X
Physician Assistant
Primary
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
08/08/2019
Last updated
07/15/2026
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