Individual
HOLLY WIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3048 E BASELINE RD, SUITE 125, MESA, AZ 85204-7286
(480) 222-0655
(480) 222-1457
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8930
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
645714
—
AZ
Enumeration date
09/07/2010
Last updated
05/09/2024
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