Individual
RENEE BETH CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E WATER ST, DECORAH, IA 52101-1801
(563) 382-6212
(563) 382-6420
Mailing address
111 E WATER ST, DECORAH, IA 52101-1801
(563) 382-6212
(563) 382-6420
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
—
IA
224900000X
Mastectomy Fitter
—
—
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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