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1629098504
MARK HALLETT
APPLETON, WI
NPI
1629098504
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207QS0010X Family Medicine, Sports Medicine
(Licence: WI 34228)
Enumeration Date
2006-07-20
Last Update Date
2011-02-02
Business Address
-- MARK HALLETT MD
820 E GRANT ST
APPLETON, WI 54911-3483
Phone number: 920-831-5050
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Mailing Address
-- MARK HALLETT MD
PO BOX 8003
APPLETON, WI 54912-8003
Phone number: 920-996-3298
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