Deborah Jo Wellman
Physical Therapy Assistant in Cahokia, IL. Individual provider (NPI-1).
NPI number1023683406
StatusActive
Last updated in NPPESMay 26, 2021
Details
- NPI
- 1023683406
- Entity type
- Individual (NPI-1)
- Name
- Deborah Jo Wellman
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 26, 2021
- Certification date
- May 26, 2021
- Last updated
- May 26, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 160.005466 | IL | Yes |
Practice location
3354 Jerome LnCahokia, IL 62206-2604
Phone 618-337-9400
Mailing address
1029 W Harnett StMascoutah, IL 62258-1034
Phone 618-406-3656
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