Dylan Wade Street - Metropolis, IL

Dylan Wade Street

Student in an Organized Health Care Education/Training Program in Metropolis, Illinois

NPI 1013471424

Dylan Wade Street is a Student in an Organized Health Care Education/Training Program based in Metropolis, IL. Dylan Wade Street practices in Metropolis, IL. The NPI Number for Dylan Wade Street is 1013471424 and holds a License No. (Illinois).

The current practice location address for Dylan Wade Street is 206 W 5Th St, Metropolis, IL and can be reached out via phone at 618-524-9368.

Location: 206 W 5Th St, Metropolis, IL, 62960-1810

NPI Number

1013471424

Provider Name

Dylan Wade Street

Credential

Provider Entity Type

Individual

Gender

Male

Address

206 W 5Th St, Metropolis, IL, 62960-1810

Phone Number

618-524-9368

Fax Number

Provider Enumeration Date

01/30/2019

Last Update Date

03/10/2024

Identifier	Type	State	Issuer
371011136002	05	IL

Address

206 W 5Th St

City

Metropolis

State

Illinois

Zip

62960-1810

Phone Number

618-524-9368

Fax Number

Address

206 W 5Th St

City

Metropolis

State

Illinois

Zip

62960-1810

Phone Number

618-524-9368

Fax Number

Type

Student, Health Care

Classification

Student in an Organized Health Care Education/Training Program

Speciality

Taxonomy

390200000X

License No.

()

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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