Individual
BENJAMIN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
(715) 845-5505
(715) 848-4884
Mailing address
425 PINE RIDGE BLVD, SUITE 211, WAUSAU, WI 54401-4123
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
158145030
WI
Other
Enumeration date
07/29/2009
Last updated
07/29/2009
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