Individual
CHARLES W WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
937 COFFEE RD, MODESTO, CA 95355-4240
(209) 529-7221
Mailing address
937 COFFEE RD, MODESTO, CA 95355-4240
(209) 529-7221
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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