Individual
MISS JESSICA JADE MARIE HAAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
5240 MCCARTHY RD, LENA, WI 54139-9534
(920) 737-5685
Mailing address
5240 MCCARTHY RD, LENA, WI 54139-9534
(920) 737-5685
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
583-039
WI
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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