Individual
MYLES E HAUGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1013 E BOXELDER RD, GILLETTE, WY 82718-5536
(307) 682-4900
(307) 687-7243
Mailing address
PO BOX 7132, GILLETTE, WY 82717-7132
(307) 682-4900
(307) 687-7243
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT#1158
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT#1158
STATE LICENSE
WY
Enumeration date
06/14/2010
Last updated
11/15/2016
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