Most Relevant Information
Provider Data
| NPI Number: | 1003039389 |
| Provider Name: | JOHN HALE LSW |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: | 1640 120 |
Most Important Dates
| Enumeration Date: | 04/11/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
100 POLK COUNTY PLZ
SUITE 50
BALSAM LAKE
WI
548109071
Practice Location Phone/Fax
| Phone: | 7154858417 |
| Fax: | 7154858490 |
Provider Mailing Location
PO BOX 32
BALSAM LAKE
WI
548100032
Provider Mailing Phone/Fax
| Phone: | 7154858417 |
| Fax: |