Individual
KEITH CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 W MINERAL KING AVE, VISALIA, CA 93291-6237
(775) 722-7245
Mailing address
PO BOX 6339, VISALIA, CA 93290-6339
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95001188
CA
Other
Enumeration date
10/02/2019
Last updated
10/10/2019
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