Carl Wallace Leder, PA-C

NPI #1619341724 in Roseburg, Oregon

Provider Information

NPI Number: 1619341724
Entity Type: Individual
Name: Carl Wallace Leder, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Dec 1, 2015
Last Updated: Feb 23, 2022

Practice Location

Address: 621 W MADRONE ST
City: Roseburg
State: Oregon
ZIP Code: 97470-3090
Phone: (541) 672-2691

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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