Individual
MRS. DIANA LYNN HAERTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 W COOK ST, PORTAGE, WI 53901-2105
(608) 742-2020
Mailing address
215 W COOK ST, PORTAGE, WI 53901-2105
(608) 742-2020
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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