Individual
IDA B HAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
221 HIGHWAY 53, SUITE D, COOK, MN 55723-5102
(218) 666-2697
(281) 666-2620
Mailing address
221 HIGHWAY 53, SUITE D, COOK, MN 55723-5102
(218) 666-2697
(281) 666-2620
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5920
MN
Other
Enumeration date
09/18/2009
Last updated
12/11/2009
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