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1841756293
CARLY LOUISE VORMEZEELE
ROCKFORD, IL
NPI
1841756293
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085.006927)
Enumeration Date
2019-02-11
Last Update Date
2021-03-03
Business Address
CARLY LOUISE VORMEZEELE PA-C
3535 N BELL SCHOOL RD
ROCKFORD, IL 61114-6624
Phone number: 779-696-9400
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Mailing Address
CARLY LOUISE VORMEZEELE PA-C
PO BOX 78866
MILWAUKEE, WI 53278-8866
Phone number: 779-696-7150
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