Individual
CARLY NICOLE WERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CARLY
Contact information
Practice address
221 NE GLEN OAK AVE, PEORIA, IL 61636-0001
(309) 672-5522
Mailing address
7150 N TERRA VISTA DR APT 301, PEORIA, IL 61614-1346
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070024730
IL
Other
Enumeration date
09/05/2019
Last updated
09/05/2019
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