Individual
KARLA MARIE HALDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5399
(618) 233-7750
Mailing address
6908 LOYET RD, COLLINSVILLE, IL 62234-6520
(618) 974-8489
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004582
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U77716965
CIGNA HEALTH
—
Enumeration date
03/22/2021
Last updated
03/22/2021
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