Individual
M'LISSA S HALDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R. P. T.
Contact information
Practice address
117 S WALNUT ST, BRAZIL, IN 47834-2622
(812) 443-6144
(812) 443-5506
Mailing address
PO BOX 563, BRAZIL, IN 47834-0563
(812) 443-6144
(812) 443-5506
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05002542
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000255598
BCBS PIN
IN
Enumeration date
09/21/2006
Last updated
12/04/2007
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