Individual
JOSEPH D HAVERKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-9357
(920) 568-6545
Mailing address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-9357
(920) 568-6545
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070017621
IL
225100000X
Physical Therapist
Primary
11842-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070017621
ILLINOIS PT LICENSE NUMBER
—
Enumeration date
02/10/2010
Last updated
01/24/2014
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