Individual
STACIE LEE HAWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
1323 CRESTON PARK DR, JANESVILLE, WI 53545-1126
(608) 756-9440
Mailing address
4412 TOUCHSTONE DR, ONEIDA, WI 54155-8662
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
9823-024
WI
Other
Enumeration date
07/25/2006
Last updated
09/24/2008
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