Most Relevant Information
Provider Data
| NPI Number: | 1003042722 |
| Provider Name: | ALICE GOERTZ MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/09/2009 |
| Last Updated: | 06/09/2009 |
Provider Practice Location
403 E MADISON ST
SOUTH BEND
IN
466172322
Practice Location Phone/Fax
| Phone: | 5742831107 |
| Fax: | 5742831256 |
Provider Mailing Location
20100 COUNTY ROAD 14
BRISTOL
IN
465079192
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |