Individual
CARLOS M WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3889 74 TH AVE N.E APT. 110, FT. TOTTEN, ND 58335
(701) 230-4641
Mailing address
8293 39TH ST NE, SAINT MICHAEL, ND 58370-9031
(701) 425-5798
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R49594
ND
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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