Organization
MED PLUS PHYSICAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW W BRETZ DC (OWNER)
(618) 594-3671
Entity
Organization
Contact information
Practice address
18209 EULA MAE PKWY, CARLYLE, IL 62231-6407
(618) 594-3671
(618) 594-8058
Mailing address
18209 EULA MAE PKWY, CARLYLE, IL 62231-6407
(618) 594-3671
(618) 594-8058
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070016995
ILLINOIS STATE LICENSE NUMBER
IL
Enumeration date
06/17/2011
Last updated
06/17/2011
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