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1295384949
CARLY NICOLE WERTZ
PEORIA, IL
NPI
1295384949
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Former Name
CARLY MILES
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070024730)
Enumeration Date
2019-09-05
Last Update Date
2019-09-05
Business Address
CARLY NICOLE WERTZ Carly
221 NE GLEN OAK AVE
PEORIA, IL 61636-0001
Phone number: 309-672-5522
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Mailing Address
CARLY NICOLE WERTZ Carly
7150 N TERRA VISTA DR APT 301
PEORIA, IL 61614-1346
Phone number:
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