Individual
MATTHEW HAISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5210 GRAND AVE, FORT SMITH, AR 72904-7362
(515) 971-0615
Mailing address
5210 GRAND AVE, FORT SMITH, AR 72904-7362
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/21/2019
Last updated
10/21/2019
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