Individual
MR. BRAD SCOTT WOLTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
173 N HARVEY AVE, OAK PARK, IL 60302-2622
(773) 213-8418
Mailing address
173 N HARVEY AVE, OAK PARK, IL 60302-2622
(773) 213-8418
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
070007821
IL
225100000X
Physical Therapist
Primary
070.007821
IL
Other
Enumeration date
04/11/2007
Last updated
08/28/2020
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