Individual
MS. KELLY JO CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17730 STAR RD, PROPHETSTOWN, IL 61277-9369
(815) 537-5973
Mailing address
17730 STAR RD, PROPHETSTOWN, IL 61277-9369
(815) 537-5973
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
IL
Other
Enumeration date
03/22/2008
Last updated
03/22/2008
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