Individual
KRISTEN ELIZABETH HAVERKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-9357
(920) 568-6545
Mailing address
1504 MADISON AVE, FORT ATKINSON, WI 53538-3100
(920) 563-9357
(920) 568-6545
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
004516
IA
225100000X
Physical Therapist
070017861
IL
225100000X
Physical Therapist
Primary
11846-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004516
PHYSICAL THERAPY LICENSE NUMBER
IA
01
—
070017861
PT LICENSE NUMBER
IL
Enumeration date
01/26/2010
Last updated
01/23/2014
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