Individual
VICTORIA HAESELBARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 BENNETT WAY, EDGARTOWN, MA 02539
(508) 627-4539
Mailing address
PO BOX 2351, 10 BENNETT WAY, EDGARTOWN, MA 02539-2351
(508) 627-4539
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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