Individual
KATIE HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
835 S MAIN ST, OCONTO FALLS, WI 54154-1282
(920) 846-8187
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13168-024
WI
Other
Enumeration date
06/29/2015
Last updated
01/12/2018
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