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Individual
MR. CRAIG ALLAN HAVERMANN
Active
Individual
MR. CRAIG ALLAN HAVERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001279
IA
2255A2300X
Athletic Trainer
00156
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00156
IOWA LICENSE, ATC
IA
01
—
089702522
NATABOC #
IA
01
—
960644
NATA MEMBER #
IA
Enumeration date
07/15/2006
Last updated
09/11/2013
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