Carl Haynes

NPI #1114438322 in West Bend, Wisconsin

Provider Information

NPI Number: 1114438322
Entity Type: Individual
Name: Carl Haynes
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: Oct 14, 2017
Last Updated: Oct 14, 2017

Practice Location

Address: 2130 CONTINENTAL DR
City: West Bend
State: Wisconsin
ZIP Code: 53095-7904
Phone: (262) 338-0092

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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