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Organization

PRESCRIPTIVE WELLNESS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CARLA WATSON MD (MD)
(773) 404-0160
Entity
Organization

Contact information

Practice address
3330 W 177TH ST STE 3F, HAZEL CREST, IL 60429-2197
(773) 404-0160
Mailing address
3330 W 177TH ST STE 3F, HAZEL CREST, IL 60429-2197
(773) 404-0160

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
036106614
IL

Other

Enumeration date
07/24/2008
Last updated
12/09/2009
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