Most Relevant Information
Provider Data
| NPI Number: | 1003305244 |
| Provider Name: | HAILEY G ROCK ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/03/2018 |
| Last Updated: | 05/03/2018 |
Provider Practice Location
1240 THAYER ST
HAMMOND
WI
540159741
Practice Location Phone/Fax
| Phone: | 7158211517 |
| Fax: |
Provider Mailing Location
1240 THAYER ST
HAMMOND
WI
540159741
Provider Mailing Phone/Fax
| Phone: | 7158211517 |
| Fax: |