Audra Hazelberg, PT, DPT

NPI #1326397191 in Ripon, Wisconsin

Provider Information

NPI Number: 1326397191
Entity Type: Individual
Name: Audra Hazelberg, PT, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT, DPT
Enumeration Date: Sep 7, 2012
Last Updated: Sep 7, 2012

Practice Location

Address: 933 NEWBURY ST
City: Ripon
State: Wisconsin
ZIP Code: 54971-1730
Phone: (920) 748-9138

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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