Jackson Edgar Haen

NPI #1033806021 in Laramie, Wyoming

Provider Information

NPI Number: 1033806021
Entity Type: Individual
Name: Jackson Edgar Haen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Nutritionist
Enumeration Date: Apr 19, 2023
Last Updated: Apr 19, 2023

Practice Location

Address: 552 N PINE ST
City: Laramie
State: Wyoming
ZIP Code: 82072-2451
Phone: (720) 256-4685

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nutritionist	133N00000X	Primary

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