Individual
LINDA JEAN HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
900 ILLINOIS AVENUE, STEVENS POINT, WI 54481-3114
(715) 346-5170
Mailing address
900 ILLINOIS AVENUE, STEVENS POINT, WI 54481-3114
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
902
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
902-039
WISCONSIN STATE LICENSE
WI
Enumeration date
08/08/2008
Last updated
08/08/2008
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