MRS. Glenice M Carlson, PAC

NPI #1134222797 in Fargo, North Dakota

Provider Information

NPI Number: 1134222797
Entity Type: Individual
Name: MRS. Glenice M Carlson, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Sep 7, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 510 4TH ST S
Address 2: PRAIRIE ST JOHNS
City: Fargo
State: North Dakota
ZIP Code: 58103
Phone: (701) 476-7239

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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