Individual
DIANA HAVERLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 IRVING STREET NW, WASHINGTON, DC 20422-4969
(202) 745-8000
Mailing address
PO BOX 337, GREAT FALLS, VA 22066-0337
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305002079
VA
Other
Enumeration date
08/26/2007
Last updated
01/09/2008
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