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Individual

BROCK H. HAUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
1815 E IRELAND RD STE 100, SOUTH BEND, IN 46614-2845
(574) 647-5790
(574) 647-5792
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008296A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201286940
IN
Enumeration date
04/16/2015
Last updated
03/20/2026
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