Individual
STEPHEN GLENN HAUBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2990 MACK RD STE 107, FAIRFIELD, OH 45014-5384
(513) 860-4801
Mailing address
6558 PARTRIDGE WAY, MASON, OH 45040-7009
(513) 560-6414
(513) 682-4186
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0027935
OH
Other
Enumeration date
12/27/2020
Last updated
12/27/2020
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