Individual
HALEY GRACE HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4415 STATE ST, APT 3, RIVERDALE, IA 52722-6311
(563) 340-6701
Mailing address
4415 STATE ST, APT 3, RIVERDALE, IA 52722-6311
(563) 340-6701
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005488
IL
Other
Enumeration date
09/04/2012
Last updated
09/04/2012
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