Individual
CARL HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2130 CONTINENTAL DR, WEST BEND, WI 53095-7904
(262) 338-0092
Mailing address
21 THATCHAM DR APT 13, CHAMPAIGN, IL 61820-2380
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070021798
IL
Other
Enumeration date
10/14/2017
Last updated
10/14/2017
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