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Individual

MATTHEW HAASE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTR/L, ATC

Contact information

Practice address
9154 ROCKEFELLER LN, SPRINGFIELD, VA 22153-1414
(703) 505-2783
Mailing address
9154 ROCKEFELLER LN, SPRINGFIELD, VA 22153-1414

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126002561
VA
225X00000X
Occupational Therapist
Primary
0119008515
VA

Other

Enumeration date
01/12/2016
Last updated
05/14/2020
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