Individual
DEBORAH JO WELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3354 JEROME LN, CAHOKIA, IL 62206-2604
(618) 337-9400
Mailing address
1029 W HARNETT ST, MASCOUTAH, IL 62258-1034
(618) 406-3656
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005466
IL
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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