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1679538789
CHARLES KEITH HAAGA
SLIDELL, LA
NPI
1679538789
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: LA J00124)
Enumeration Date
2006-04-20
Last Update Date
2007-07-08
Business Address
Mr. CHARLES KEITH HAAGA ATC
1104 CHARLIE DR
SLIDELL, LA 70461-5346
Phone number: 985-781-1635
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Mailing Address
Mr. CHARLES KEITH HAAGA ATC
1104 CHARLIE DR
SLIDELL, LA 70461-5346
Phone number: 985-781-1635
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