Individual
ADAM HASLAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
(877) 787-3430
Mailing address
9419 STONEY GAP RD, JEFFERSON CITY, MO 65101-9517
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2012025875
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2012025875
MO BOARD OF HEALING ARTS
MO
Enumeration date
06/09/2021
Last updated
06/09/2021
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