Individual
TROY ADAM HASELIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OWNER
Contact information
Practice address
39349 RIVER DR, LEBANON, OR 97355-8915
(541) 971-5469
Mailing address
39349 RIVER DR, LEBANON, OR 97355-8915
(541) 971-5469
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
9570911
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26-3985015
—
OR
Enumeration date
02/15/2018
Last updated
02/15/2018
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