Carlyn Wade

NPI #1033447396 in Santa Fe, New Mexico

Provider Information

NPI Number: 1033447396
Entity Type: Individual
Name: Carlyn Wade
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Nov 25, 2009
Last Updated: Nov 25, 2009

Practice Location

Address: 2446 AVENIDA CHAPPARAL
City: Santa Fe
State: New Mexico
ZIP Code: 87505-5500
Phone: (505) 474-5969

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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