Individual
MISS CARLY MARIE STOHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1000 E BRIGHTON LN, CRYSTAL LAKE, IL 60012-2074
(815) 477-6400
Mailing address
420 LELAND ST, OTTAWA, IL 61350-3350
(815) 326-0455
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006089
IL
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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