Individual
CASSANDRA RAE HAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6303 S ADAMS ST, BARTONVILLE, IL 61607-2517
(309) 363-6961
Mailing address
6303 S ADAMS ST, BARTONVILLE, IL 61607-2517
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004911
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370686250001
—
IL
Enumeration date
08/01/2011
Last updated
08/01/2011
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