Individual
DANIEL WALTER HAECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2955 PROFESSIONAL PL, SUITE 201, COLORADO SPRINGS, CO 80904-8139
(719) 591-5545
(719) 591-5540
Mailing address
3030 N CIRCLE DR, STE 210, COLORADO SPGS, CO 80909-1180
(719) 228-9440
(719) 228-9061
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
594
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08581886
—
CO
Enumeration date
05/15/2006
Last updated
02/21/2019
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