Individual
MILES ALAN HAEBERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
611 CLINIC RD, CHALLIS, ID 83226-4824
(208) 879-4351
(208) 879-5216
Mailing address
PO BOX 980, CHALLIS, ID 83226-0980
(208) 879-4351
(208) 879-5216
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/20/2017
Last updated
06/01/2020
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