Dylan Wade Street
Dylan Wade Street is a Student in an Organized Health Care Education/Training Program in Metropolis, Illinois. Practices as a sole proprietor. Registered with an NPI since 2019.
- In the registry since
- 2019
Practice location Address checks out
206 W 5th StMetropolis, IL 62960-1810
Phone: (618) 524-9368
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1013471424 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | January 30, 2019 |
| Last updated in NPPES | January 30, 2019 |
| Mailing address | 206 W 5th St, Metropolis, IL 62960-1810 |
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