Individual
THOMAS HABERLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
HOPI HEALTH CARE CENTER, HIGHWAY 264 MP 388 PO BOX 4000,, POLACCA, AZ 86042
(928) 737-6000
Mailing address
PO BOX 1434, KEAMS CANYON, AZ 86034-1434
(253) 753-8972
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN130404
AZ
Other
Enumeration date
07/12/2017
Last updated
07/12/2017
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