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Organization
PRESCRIPTIVE WELLNESS LLC
Active
Organization
PRESCRIPTIVE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLA WATSON MD (MD)
(773) 404-0160
Entity
Organization
Contact information
Practice address
3330 W 177TH ST STE 3F, HAZEL CREST, IL 60429-2197
(773) 404-0160
Mailing address
3330 W 177TH ST STE 3F, HAZEL CREST, IL 60429-2197
(773) 404-0160
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
036106614
IL
Other
Enumeration date
07/24/2008
Last updated
12/09/2009
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