Individual
BRYCE HAISTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2121 W HWY 6, WACO, TX 76710-4021
(254) 845-7935
Mailing address
330 SHARRON DR, WOODWAY, TX 76712-3351
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2157711
TX
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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