TODD KARL HAACKE

PROVO, UT
NPI1154023513
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: UT  11412274-2401)
Enumeration Date2023-03-20
Last Update Date2023-06-07
Business Address
TODD KARL HAACKE DPT
1055 N 500 W
PROVO, UT 84604-3305
Phone number: 801-429-0610
Mailing Address
TODD KARL HAACKE DPT
1055 N 500 W ATTN: CREDENTIALING
PROVO, UT 84604-3305
Phone number: 801-354-8225
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