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Individual

HAYLEY GAFFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
327 N 17TH AVE STE 7, WAUSAU, WI 54401-4283
(715) 845-2942
(715) 842-3416
Mailing address
24014 W RENWICK RD, STE F, PLAINFIELD, IL 60544-8708
(800) 974-4378
(630) 515-1536

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1246068
TX
225100000X
Physical Therapist
Primary
15294-24
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
340719901
TX
01
86TT62
BLUE CROSS BLUE SHIELD
TX
01
P01425845
MEDICARE RAILROAD
TX
Enumeration date
08/12/2014
Last updated
02/01/2021
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