Individual
CAROL O WENTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MASSAGE THERAPIS
Contact information
Practice address
253 W MAIN ST, KUTZTOWN, PA 19530-1641
(610) 256-9297
Mailing address
PO BOX 339, NEW BERLINVILLE, PA 19545-0339
(610) 256-9297
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN254548L
PA
163WM1400X
Nurse Massage Therapist (NMT)
Primary
RN254548L
PA
Other
Enumeration date
03/30/2010
Last updated
05/01/2010
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