Individual
AUDRA HAZELBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
933 NEWBURY ST, RIPON, WI 54971-1730
(920) 748-9138
Mailing address
933 NEWBURY ST, RIPON, WI 54971-1730
(920) 748-9138
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11991-24
WI
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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