Individual
MICHELLE NICOLE BELTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRT
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
705 PAWNEE DR, DU QUOIN, IL 62832-2557
(618) 542-3929
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
194007504
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194007504
RESPIRATORY
IL
Enumeration date
09/07/2012
Last updated
09/07/2012
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