Individual
HALEY KRISTINE LAQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
713 W WADE HAMPTON BLVD, GREER, SC 29650-1307
(864) 479-6084
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12377
SC
225100000X
Physical Therapist
—
—
Other
Enumeration date
06/10/2022
Last updated
06/13/2024
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