Individual
MR. JASON STEWART HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT-B
Contact information
Practice address
BLD 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FT. RUCKER, AL 36362-5333
(334) 255-7636
(334) 255-7368
Mailing address
BLD 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FT. RUCKER, AL 36362-5333
(334) 255-7636
(334) 255-7368
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E1726952
TX
Other
Enumeration date
08/29/2013
Last updated
08/29/2013
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